Feb 25, 2014 - 5:20 pm
Three and a half years out from treatment, I had a dental crown fail catastrophically. Turns out it was completely decayed through from beneath, and the tooth itself was shattered. After numerous discussions with my oncology team, dentist, endodontist, and maxillofacial surgeon with special expertise in osteoradionecrosis... I have a better understanding of the situation. The Osteoradionecrosis specialist is appalled that anyone is allowed to go through the head/neck radiation treatment regime WITHOUT mandatory removal of the back two molars from each side of the lower jaw. The blood flow to the bone in these areas is severely damaged by the rads, the teeth themselves are damaged by the rads, saliva is compromised, etc. I was warned that I was much more prone to decay but I wasn't told that crowns were much more susceptible to bacterial attack up through the bottom and that they could fail from the inside.
I have four crowns, on these back four teeth. The dentist and endodontist were focused on the one tooth that failed. I took myself to the ORN specialist, and he was the only one to recommend a panorex dental x-ray to see what else was brewing. Turns out one of the back teeth on the opposite site is also nursing decay under the crown and has an abscessed root. These things aren't even causing me any pain - in part, I suspect, owing to radiation damage.
So, ORN guy says NO WAY should I have even a single tooth extracted if there is any way to save even just the root. Hyperbaric Oxygen would help, but there is no guarantee that this will prevent ORN from happening. He said to forget any idea I might have had about extracting multiple teeth now. The time for that is long past. ORN is so nasty that he won't let me.
So the Endodontist did a root canal today on the shattered tooth. Yeouch. Face is now swelled up like a chipmunk. I'm waiting for a call back from my dentist, to schedule the crown... or button... or seal... or whatever she can come up with to cover what is left of the tooth. And, looking forward to having a second root canal on the other side.
Take-away lesson from this. If you haven't started treatment yet, you might want to get those back bottom teeth removed, even if they are covered with pretty crowns and look perfect.
Deb - the chipmunk face