special care for dental work?

debbiejeanne
debbiejeanne Member Posts: 3,102 Member

hi, i had 35 rad tx to my larynx which ended 10/22/09.  because the larynx is farther down the throat and more away from the teeth, i'm wondering if i still need special care to have a tooth pulled?  I'm getting one pulled next Tuesday but was thinking since my teeth weren't directly in the line of rads, i should be ok.  what are your thoughts?  i don't have someone in the professional field to ask this question.  i don't think the dentist has other H&N C patients so I don't think he would have the answer.  I googled dentist today to see if I could find one familiar with H&N C patients but none were listed.  I know I can't put up with the pain of this tooth much longer as the pain is getting pretty bad and causes more pain if i drink something (hot and cold make it hurt) or try to eat.  your feedback will be greatly appreciated.  if you know who i should ask professionally, i'd appreciate that advice also.  thank you.

dj

Comments

  • KTeacher
    KTeacher Member Posts: 1,103
    Teeth

    I had a tooth pulled post treatment.  I did not have HBO.  Did not go to regular dentist, he sent me to a peridontist.  I was checked weekly.  I was given a rinse, Chlorhexidine Gluconate 0.12%, I did not rinse with it, just used a q-tip and applied to the area.  It took me a little longer to heal but I also have type 2 diabetes.  Peridontist did contact Radiologist to get info on my radiation treatment before extraction.  Half my head is numb so I only chew on the left side.  Good luck with your treatment.

  • LumpinmyThroat
    LumpinmyThroat Member Posts: 98
    Dental Oncologist

    We saw a dental oncologist at MDA about 2 weeks ago. My husbands cancer is in his trachea and they indicated the radiation would not impact the teeth, so we would never require their services. I don't know if that helps but it leads me to believe that special care is not needed. Maybe you could call a dental oncologist for advice? Always best to ask a doctor that knows what they're talking about in special cases. I know finding that doctor is the hard part, but worth the peace of mind.

  • ratface
    ratface Member Posts: 1,337 Member
    Ask your Rad/Oncologist

    MY dentist refers to my rad oncologist whenever he needs to know where the fields of radiation were concentrated.  I assume your radiation was IMRT which would have been well controlled. Where is the tooth, upper or lower? Upper is less prone to complication because of bone density and absorbtion. What is the potential for damaging nearby tissue, is it a simple extraction or a hard to get at wisdom tooth? One of the questions that my dentist has on his new patients form is, "Have you ever had cancer" which would immediately lead to a conversation about extractions.  All that said, if my Rad oncologist said it was ok I might tend to be somewhat not forthcoming with additional information as dentists tend to get skiddish and over react, sometimes insisting on HBO when it's really not needed. You are in one of those situations where you could make the procedure more complicated than it needs to be.

  • debbiejeanne
    debbiejeanne Member Posts: 3,102 Member
    ratface said:

    Ask your Rad/Oncologist

    MY dentist refers to my rad oncologist whenever he needs to know where the fields of radiation were concentrated.  I assume your radiation was IMRT which would have been well controlled. Where is the tooth, upper or lower? Upper is less prone to complication because of bone density and absorbtion. What is the potential for damaging nearby tissue, is it a simple extraction or a hard to get at wisdom tooth? One of the questions that my dentist has on his new patients form is, "Have you ever had cancer" which would immediately lead to a conversation about extractions.  All that said, if my Rad oncologist said it was ok I might tend to be somewhat not forthcoming with additional information as dentists tend to get skiddish and over react, sometimes insisting on HBO when it's really not needed. You are in one of those situations where you could make the procedure more complicated than it needs to be.

    yeah, i had imrt.  the tooth

    yeah, i had imrt.  the tooth is on the bottom in the back.  it would just be a normal extraction.  i think iwill just get the damn thing pulled and be done.  thanks everone,

    dj

  • hwt
    hwt Member Posts: 2,328 Member

    yeah, i had imrt.  the tooth

    yeah, i had imrt.  the tooth is on the bottom in the back.  it would just be a normal extraction.  i think iwill just get the damn thing pulled and be done.  thanks everone,

    dj

    DJ

    I'm thinking ask the radiologist's office

  • Hondo
    Hondo Member Posts: 6,636 Member

    yeah, i had imrt.  the tooth

    yeah, i had imrt.  the tooth is on the bottom in the back.  it would just be a normal extraction.  i think iwill just get the damn thing pulled and be done.  thanks everone,

    dj

    Hi Debbie

    I always ask my ENT before I do anything any place on my neck or head. The last time I pulled a wisdom tooth it cost me a little over 4 thousand dollars with all the HBO treatment and doctors. But remember I different because I took so much radiation to the face.

    My rule of thump is always ask first

    Tim Hondo

  • lornal
    lornal Member Posts: 428
    Lary

    After my laryngectomy, when deciding whether to do radiation or not, the radiation oncologist mentioned that radiation this time would affect the teeth, since it was low enough.

    (Also said I have execellent teeth considering they probably were radiated with the first cancer.)

    Lorna

    2007 and 2014

  • michdjp
    michdjp Member Posts: 220
    Teeth

    Hi dj,

    my dad just went to the dentist who recommended he have 2 teeth pulled.  He referred him to an oral surgeon who said under no circumstances would he pull the teeth.  If he absolutely had to pull them, he needed to go to the oxygen chambers first in order to heal The jaw.  So we went to an endodontics dentist and thankfully, he was able to root canal the tooth.  He still has 2 more teeth that are severely decayed and he will try the root canal on them as well.  all drs. Seemed to agree to try everything before pulling them even if just shaving them down and filling them was better than pulling them.  My dad had imrt and 3 chemos for tonsil and lymph node, stage 4a.  He finished tx in 10-11.   I hope this helps.

    all my best, MichelleMichelle

  • CajunEagle
    CajunEagle Member Posts: 408
    michdjp said:

    Teeth

    Hi dj,

    my dad just went to the dentist who recommended he have 2 teeth pulled.  He referred him to an oral surgeon who said under no circumstances would he pull the teeth.  If he absolutely had to pull them, he needed to go to the oxygen chambers first in order to heal The jaw.  So we went to an endodontics dentist and thankfully, he was able to root canal the tooth.  He still has 2 more teeth that are severely decayed and he will try the root canal on them as well.  all drs. Seemed to agree to try everything before pulling them even if just shaving them down and filling them was better than pulling them.  My dad had imrt and 3 chemos for tonsil and lymph node, stage 4a.  He finished tx in 10-11.   I hope this helps.

    all my best, MichelleMichelle

    I concur

    I completed treatment for stage 4....left tonsil....5 years ago, and about this time last year I began to have a soreness issue in the area of my left lower molar ( #17).  My regular Dentist took x-rays, and could see no problem with the tooth, but there was some redness where the gum met the Molar and put me on an antibiotic, which eventually ceased the soreness.....but a month later it returned.  By the Fall of last year, she referred me to an oral surgeon who then set me up with a Root Canal specialist, and a procedure was done in November.  By January of this year, that root canaled Molar area was still quite sore, and I basically couldn't eat by chewing on the left side.  So, back to Oral Surgeon who told me it was still infected, and placed me on stronger antibiotics, which knocked out the infection, but only for a few weeks when it would return.  Standard dental hygene for me is usage of Prevident 5000 dry mouth toothpaste at least 3 times a day, Water Pic used 3 times a day with Act mouthwash, and use of molded teeth trays filled with Colgate Gel-Kam...20 minutes per day.  Regular Dentist visits with cleaning and exams are done every 4 months.  I'm seeing the Oral Surgeon now at least once a month just to keep an eye out on that Molar.  During his last examination last week, he informed me that the redness and puffiness were still present and some jaw bone was starting to be exposed.  An ex-ray will be done at the end of this month to determine the next steps.

    Larry 

  • debbiejeanne
    debbiejeanne Member Posts: 3,102 Member

    I concur

    I completed treatment for stage 4....left tonsil....5 years ago, and about this time last year I began to have a soreness issue in the area of my left lower molar ( #17).  My regular Dentist took x-rays, and could see no problem with the tooth, but there was some redness where the gum met the Molar and put me on an antibiotic, which eventually ceased the soreness.....but a month later it returned.  By the Fall of last year, she referred me to an oral surgeon who then set me up with a Root Canal specialist, and a procedure was done in November.  By January of this year, that root canaled Molar area was still quite sore, and I basically couldn't eat by chewing on the left side.  So, back to Oral Surgeon who told me it was still infected, and placed me on stronger antibiotics, which knocked out the infection, but only for a few weeks when it would return.  Standard dental hygene for me is usage of Prevident 5000 dry mouth toothpaste at least 3 times a day, Water Pic used 3 times a day with Act mouthwash, and use of molded teeth trays filled with Colgate Gel-Kam...20 minutes per day.  Regular Dentist visits with cleaning and exams are done every 4 months.  I'm seeing the Oral Surgeon now at least once a month just to keep an eye out on that Molar.  During his last examination last week, he informed me that the redness and puffiness were still present and some jaw bone was starting to be exposed.  An ex-ray will be done at the end of this month to determine the next steps.

    Larry 

    wow, Larry, you have a lot

    wow, Larry, you have a lot going on.  thank you for your reply and I'm praying the dentist can fix your tooth once and for all and without much pain.  if you're like me right now tho, you're already in pain everyday and doing something with the tooth will be a relief.  good luck, friend.

    dj