More Dental Stuff

fishmanpa
fishmanpa Member Posts: 1,227 Member

Hi Folks,

I've been following Sheilarhc's post on dental implants. I know prior to treatment I had to be cleared by my dentist. I had one tooth removed and a cavity filled as well as a thorough cleaning. My dentist recommended using a childrens fluoride rinse (Listerine) as opposed to trays. I rinse with it twice a day (am & pm). It has a pleasent taste and no burn. I found it difficult to maintain a normal schedule of brushing and rinsing due to the side effects but I managed to at least brush a minimum of once a day and rinse. While I don't have perfectly healthy teeth, my dentist said that mine were in pretty good shape and should fair well. The only side effect I feel is a sensitivity to cold liquids. 

Reading through this and other H&N cancer forums I've noticed that dental issues are prevelent for many. It also seems to be more prevelent for those that had radiation more than 5 years ago. In other words, it appears that those that received external beam therapy as opposed to IMRT have more dental issues. I may be fortunate and not experience any issues but it seems most everyone does to some extent. 

Thus my questions....

For those experiencing dental issues, what type of radiation therapy did you receive? How many treatments did you have? How were your teeth prior? Did you use fluoride treatments/trays/rinse? How long was it until you started noticing issues? 

I want to get an idea of what I should be looking out for in the future.

Thanks! 

Positive thoughts and prayers,

"T"

«13

Comments

  • rachel12yrsuv
    rachel12yrsuv Member Posts: 435
    T,
    external tx, teeth in

    T,

    external tx, teeth in super great shape Prior.  They wanted to pull all molars prior to starting I said no, hindsight I wish I had.  I had trays and used them as I could tolerate the taste gagged me and with food aversion made me I'll.  although I required much dental work over the years it took 8 before I lost any.  I am now looking at removing the balance and getting dentures , they are so soft and brittle once I finally eat something of substance I'm sure another one will break.  It has been my hardest pill to swallow, I had awesome teeth and was very proud of them and now YUCK, see that's why excessive pride is a sin, sorry God! Lol

    hope this helps!  Take care Buddy!

    RAchel

     

  • SeaUSoon
    SeaUSoon Member Posts: 5
    Dental

    I had IMRT

    33 sessions

    72Gy

    52-55 Gy to mandible

    Used fluoride rinse

    Teeth started flaking off and turning to powder at about 4 mths post treatment

    Had good teeth prior and dental work prior

    Just finished 20 hyperbaric oxygen chamber treatments and had all teeth extracted yesterday. Have 10 more HBO treatments starting tomorrow

    Hope this helps ya!

    Walt

  • D Lewis
    D Lewis Member Posts: 1,581 Member
    Almost three years out

    Had IMRT, 36 sessions, "68.4 GY with 150 mg/M2 total", fried both sides of my mouth.  Dental hygene was great going in, several fillings dating from my youth, several crowns as a young adult, no inflammation or gum disease. 

    My tongue and gums were so badly burned I was unable to brush for the duration of my treatment. I flossed gently with fluoride floss, rinsed and swished, and used fluoride trays whenever I could stand it. Since then, I have brushed four or more times per day with Prevident, and continued the use of fluoride floss.  I have no saliva, and it's difficult to clear the food from my mouth and from between my teeth, after eating.  I use the Biotene rinse.

    Since end of treatment, I've had two fillings replaced with crowns, as they were old, and cracked and rapid decay started.  Had no ill effects, and they healed up okay.  No hyperbaric treatment, although my ENT insists I will have it, if I ever need an extraction. Dentist is very pleased with my hygene and gums.  I'm not so pleased with the way the teeth look, but they seem solid for now.  Seems like they darkened a bit, after radiation.

    I am hesitant to bleach them because I've no idea how it will turn out, absent saliva.

    Deb

  • Sheilarhc
    Sheilarhc Member Posts: 46
    Wow….I had no idea so many

    Wow….I had no idea so many other people have had similar issues. I guess I thought I was the only one. I’ve found great comfort and information regarding this topic since I started the forum. 60Gy IMRT (believe it was 35 treatments) Teeth were perfect prior to treatment. Started having trouble 2-3 years after treatment. Facial swelling and random fevers landed me in the ER several times before an ER doctor told me he thought it could be related to my teeth. I thought he was crazy because I saw my dentist every three months and used a fluoride rinse and I had NO tooth pain. The dentist I was seeing back then always told me that my teeth were perfect and unaffected by the radiation. I asked him for fluoride trays several times and he told me I didn’t need them…..how wrong he was. I have terrible gum recession and pain. I’ve had 4 teeth extracted on the bottom (20 dives in the hyperbaric oxygen chamber). Several root canals and recently all my top teeth were crowned. Had my first gum graphing maybe a month or so ago and it was a complete failure. The new tissue didn’t graph to my old tissue and now I have more root exposure than before the surgery. My struggle continues and next week I find out if they are going to attempt the gum graphing again. I hate that I live on pain meds, I hate that I’d rather starve than put myself through the agony of using my teeth, I hate that radiation has caused so much grief in my life yet I’m grateful it helped save my life. I’ve felt so alone with this struggle as many do not understand. Thank you for keeping the discussion going, I no longer feel alone and I’ve learned so much reading everyone’s experiences. Thank you, thank you, thank you and God bless

     

  • hwt
    hwt Member Posts: 2,328 Member
    Sheilarhc said:

    Wow….I had no idea so many

    Wow….I had no idea so many other people have had similar issues. I guess I thought I was the only one. I’ve found great comfort and information regarding this topic since I started the forum. 60Gy IMRT (believe it was 35 treatments) Teeth were perfect prior to treatment. Started having trouble 2-3 years after treatment. Facial swelling and random fevers landed me in the ER several times before an ER doctor told me he thought it could be related to my teeth. I thought he was crazy because I saw my dentist every three months and used a fluoride rinse and I had NO tooth pain. The dentist I was seeing back then always told me that my teeth were perfect and unaffected by the radiation. I asked him for fluoride trays several times and he told me I didn’t need them…..how wrong he was. I have terrible gum recession and pain. I’ve had 4 teeth extracted on the bottom (20 dives in the hyperbaric oxygen chamber). Several root canals and recently all my top teeth were crowned. Had my first gum graphing maybe a month or so ago and it was a complete failure. The new tissue didn’t graph to my old tissue and now I have more root exposure than before the surgery. My struggle continues and next week I find out if they are going to attempt the gum graphing again. I hate that I live on pain meds, I hate that I’d rather starve than put myself through the agony of using my teeth, I hate that radiation has caused so much grief in my life yet I’m grateful it helped save my life. I’ve felt so alone with this struggle as many do not understand. Thank you for keeping the discussion going, I no longer feel alone and I’ve learned so much reading everyone’s experiences. Thank you, thank you, thank you and God bless

     

    Dental

    T,

    I had periodontal disease since my 20s. Some 30+ years of planing and scaling, root canals and crowns. I put so much time, energy and money into keeping my own teeth only to have them pulled to remove the cancer in my lower jaw. Since tx, I have had 1 root canal. There was no exterior decay on that tooth so they felt the radiation destroyed the root internally. I could only wear my floride trays 2 or 3 weeks into tx then it just burned too bad. For months, I was only able to us MI Paste which is a polishing paste but it didn't burn. I just finished HBOT 30 dives in anticipation of implants to hold a permanent denture.  

  • Skiffin16
    Skiffin16 Member Posts: 8,305 Member
    Skiffin ~ IMRT April-June 2009

    Though I haven't hit the five mark yet, I had;

    IMRT

    35 daily rads sessions

    Right Side - 70Gy

    Left Side - 60Gy

    Never had the greatest of teeth going in..., many fillings throughout the years. A Root Canal and Crown B4 Tx.

    Since Tx, a few more fillings, two crowns, not that uncommon based on my history the last several years.

    I used the Oral B- STOP Fluoride Gel, and still do, only once or twice a week now. I used it pretty much daily during and right after treatment for the first year or so.

    JG

  • metro22
    metro22 Member Posts: 16
    extractions

    My surgery at mayo late March was Tonsil area, hypopharynx and nodes in neck.  Will begin rads as soon as my dental work  heals.  One radiation oncologist agrees that data about osteonecrosis uses much data from older machines and today control is better. However my Radiation oncologist strongly recommends to all to remove all teeth as she has seen  osteonecrosis. I think most now suggest removal of all 12 molars as they are more in the path of the rads. I went to and Oncology Suppoprt Dentist as we selected 15 teeth to go leaving some front upper and lowers to help hold futures dentures. 5 hours ago I started the 2 hour procedure to remove 15 teeth  and at the moment I am biting on  wet  tea bags wrapped in a layer of gauze as the  tannic acid in the tea bag helps to form a clot by contracting bleeding vessels. One wisdom tooth was impacted and the surgeon was even worried that my  jaw may break on its removal. It didn’t so hopefully in a few years it may get stronger. I took a double dos roxicet 5/325 2 hours ago and it took the edge off but paid still about 5+. They said typically the worst day is the third day and then it improves.

    My dental surgeon believes that after rads the upper jaw, blood supply improves a lot after 2-3 years and is they safer to do extraction. The lower jaw takes longer and may not recover as much so even more caution.

     

    Wow – even  though it has only been 2 hours since taking my roxicet the pain just now is increasing toward an 8 or 9 – I think I will try the lower dose but every  two hours – yikes this hurts  - but trying to prevent possible terrible situation in the futures, Wishing all well

  • donfoo
    donfoo Member Posts: 1,771 Member
    scaring me

    Damn,

    All this talk of busted and broken and disintegrated bones makes me shake. Now, overall the percentage of ppl losing teeth or having major jawbone issues seems quite low to me. It just feels like this thread brought out the tigers from the jungle.

     

    I had two teeth extracted as they were abscessed and not doing anything particular now other than regular brusing with a flouride paste. My saliva production remains good and dry mouth is not an issue for me at present.

  • Hondo
    Hondo Member Posts: 6,636 Member
    Hi fishmanpa

     

    I am right at 7 ½ years out of my second rad treatment and I have been using SF 5000 Plus when brushing my teeth. For me it was a life savior because of my jaw problems and not being able to use the tray. I am going to get a tooth removed next month and for me that is a surgery because I can’t open the jaw very wide. Then after that it is ten HBO treatments, so here we go again.

     

    Take care

    Hondo

  • fishmanpa
    fishmanpa Member Posts: 1,227 Member
    Oncology Dentist

    I've been reading about this on several forums and it appears it affects everyone to some degree down the line. Enough so that it warrants a visit to a dentist that specializes in H&N cancer. There is a dental office at Johns Hopkins specifically geared toward H&N in the Sidney Kimmel Cancer Center. I'm going to arrange an appointment in the not too distant future to get checked out. 

    With the price of a crown coming in at roughly $1K per tooth, all I know is I better start saving $$$ now! Thanks for the replies thus far... you guys are great!

    "T"

  • phrannie51
    phrannie51 Member Posts: 4,716

    has me grateful that I already had dentures when I started treatment.  I'm sure if I'd had teeth at the beginning of treatment, that I too would have been slated for removal before it started....and would have had to spend 6 months without any teeth before dentures could be made.  As it was, the last 3 months of treatment I could only wear them one week out of every three (embarrassing as hell for me, as I'd never gone a full hour in my life without them....and here I was having to face the world everyday toothless). 

    I feel for the person who had 15 teeth pulled with no denture to slap into their place....it sounds horrible placing a denture onto newly pulled teeth, but in reality it saves a lot in the pain department. 

    p

  • fishmanpa
    fishmanpa Member Posts: 1,227 Member
    donfoo said:

    scaring me

    Damn,

    All this talk of busted and broken and disintegrated bones makes me shake. Now, overall the percentage of ppl losing teeth or having major jawbone issues seems quite low to me. It just feels like this thread brought out the tigers from the jungle.

     

    I had two teeth extracted as they were abscessed and not doing anything particular now other than regular brusing with a flouride paste. My saliva production remains good and dry mouth is not an issue for me at present.

    Bungle in the Jungle

    I don't know Foo,

    I've read some recent threads that have been talking about dental issues from rads. It's more of a long term issue but  I've not seen a post on any forum that said "Great teeth going in, no problems since". 

    I don't think I can do much more to head off potential issues but I do want the straight dope on it. In the mean time I'm not going to stress about it. Worst case is I have to get dentures... ehh... big deal. With heart disease and now cancer, there are several factors that can take me out and teeth aren't one of them ;)

    Positive thoughts and prayers

    "T"

     

  • MarineE5
    MarineE5 Member Posts: 1,030 Member
    You will find a routine that works for you

    "T"

    I had 30 Rads done by the IMRT over 8 yrs ago. The first 5 years, I saw a Cancer H & N Dentist at the hospital that I had the surgery, along with my local Dentist that also volunteered at the VA. In the first 5 yrs, I used Perio-Check Flouride along with the Trays. I had 2 teeth crack one evening due to me biting into something hard. I had 2 caps put on by the local Dentist.

    After my 5 years, I went to the VA Dentist that suggested I used Previ-Dent 5000 Flouride Toothpaste as it wouldn't brown my teeth like the Perio-Check Flouride did. The Previ-Dent has the same Flouride as the Perio-Check and no need for the Trays. Basically the same procedure though. Instead of the trays, brush it on, spit out excess and don't rinse mouth for 30 minutes. I tend to over due things, so I go for an hour if possible and I have zero saliva, so it isn't too hard for me to do this. After that time, I rinse and gargle before sipping water or eating. All this doesn't have to be done at a certain time each day, but should be done at least once a day. Do it around your schedule, and you will stay with the program.

    I recently had my teeth cleaned again at the VA and was told that I am doing a great job, so I hope to continue to have good reports. I haven't given up sweets altogether as there are a few things I can taste. Just make it a point to brush shortly afterwards, that is the main thing. My teeth at the beginning of all of this were borderline remove all or keep what I had. I chose to keep them and have been able to so far.

    My Best to You and Everyone Here

  • hawk711
    hawk711 Member Posts: 566
    Sheilarhc said:

    Wow….I had no idea so many

    Wow….I had no idea so many other people have had similar issues. I guess I thought I was the only one. I’ve found great comfort and information regarding this topic since I started the forum. 60Gy IMRT (believe it was 35 treatments) Teeth were perfect prior to treatment. Started having trouble 2-3 years after treatment. Facial swelling and random fevers landed me in the ER several times before an ER doctor told me he thought it could be related to my teeth. I thought he was crazy because I saw my dentist every three months and used a fluoride rinse and I had NO tooth pain. The dentist I was seeing back then always told me that my teeth were perfect and unaffected by the radiation. I asked him for fluoride trays several times and he told me I didn’t need them…..how wrong he was. I have terrible gum recession and pain. I’ve had 4 teeth extracted on the bottom (20 dives in the hyperbaric oxygen chamber). Several root canals and recently all my top teeth were crowned. Had my first gum graphing maybe a month or so ago and it was a complete failure. The new tissue didn’t graph to my old tissue and now I have more root exposure than before the surgery. My struggle continues and next week I find out if they are going to attempt the gum graphing again. I hate that I live on pain meds, I hate that I’d rather starve than put myself through the agony of using my teeth, I hate that radiation has caused so much grief in my life yet I’m grateful it helped save my life. I’ve felt so alone with this struggle as many do not understand. Thank you for keeping the discussion going, I no longer feel alone and I’ve learned so much reading everyone’s experiences. Thank you, thank you, thank you and God bless

     

    Sheila and Metro specifically, but questions for all

    Hi All:

    I am 3 years post treatment and am now have huge issues with my jaw.  I think it is teeth related but not sure yet.  Have MRI this week.

    About 3 weeks ago, I had a swollen, infected left jaw.  Believe I had an infection in my Massoteric space (muscle).  ANyway, great pain at this time.  My dentist says pain could have come from a tooth.  All my teeth feel and look o.k. but she said that doesn't matter, it could be the root cause for the infection.  In reading your comments, I think I am having many of the same issues you two have had or are having.  I had no issues for 3 yeasrs and now WHAM, I got big issues.  I also cannot open my jaw more than 1" and was over 2" 4 weeks ago.  Did you all have this issue when you had the teeth issues????   I will try to keep this topic going as I think the teeth are the issue that all the newbies may have in 2-4 years and should be discussing with their doctors now....I'm sure that many who were on the site 3-4 years ago just don't come back to this site and report how they are doing.  I know DLewis and I are the older posters on this site, next to Skiffin and Hondo.

    I'll let you all know what my MRI shows and keep you advised.  My dentist says that HB Chamber may be necessary for me if I need to have teeth extracted too.  

    Live each day happy, all the best,

    steve

  • Skiffin16
    Skiffin16 Member Posts: 8,305 Member
    fishmanpa said:

    Bungle in the Jungle

    I don't know Foo,

    I've read some recent threads that have been talking about dental issues from rads. It's more of a long term issue but  I've not seen a post on any forum that said "Great teeth going in, no problems since". 

    I don't think I can do much more to head off potential issues but I do want the straight dope on it. In the mean time I'm not going to stress about it. Worst case is I have to get dentures... ehh... big deal. With heart disease and now cancer, there are several factors that can take me out and teeth aren't one of them ;)

    Positive thoughts and prayers

    "T"

     

    Thick As A Brick...

    Man, I must be "Thick As A Brick"...

    it's been awhile, LOL...

    JG

  • jim and i
    jim and i Member Posts: 1,788 Member
    MarineE5 said:

    You will find a routine that works for you

    "T"

    I had 30 Rads done by the IMRT over 8 yrs ago. The first 5 years, I saw a Cancer H & N Dentist at the hospital that I had the surgery, along with my local Dentist that also volunteered at the VA. In the first 5 yrs, I used Perio-Check Flouride along with the Trays. I had 2 teeth crack one evening due to me biting into something hard. I had 2 caps put on by the local Dentist.

    After my 5 years, I went to the VA Dentist that suggested I used Previ-Dent 5000 Flouride Toothpaste as it wouldn't brown my teeth like the Perio-Check Flouride did. The Previ-Dent has the same Flouride as the Perio-Check and no need for the Trays. Basically the same procedure though. Instead of the trays, brush it on, spit out excess and don't rinse mouth for 30 minutes. I tend to over due things, so I go for an hour if possible and I have zero saliva, so it isn't too hard for me to do this. After that time, I rinse and gargle before sipping water or eating. All this doesn't have to be done at a certain time each day, but should be done at least once a day. Do it around your schedule, and you will stay with the program.

    I recently had my teeth cleaned again at the VA and was told that I am doing a great job, so I hope to continue to have good reports. I haven't given up sweets altogether as there are a few things I can taste. Just make it a point to brush shortly afterwards, that is the main thing. My teeth at the beginning of all of this were borderline remove all or keep what I had. I chose to keep them and have been able to so far.

    My Best to You and Everyone Here

    Specialist Dentist

    Do you need a Head and Neck cancer dentist? They pulled Jims back teeth and cut off a bridge before treatment, now his remaining teeth are crumbling. We cannot afford a specialist and probably not a regular dentist. Does Medicare cover the removal of teeth?

     

    Debbie

  • fishmanpa
    fishmanpa Member Posts: 1,227 Member
    Skiffin16 said:

    Thick As A Brick...

    Man, I must be "Thick As A Brick"...

    it's been awhile, LOL...

    JG

    Life's a Long Song

    But the tune ends too soon for the song...

    "T"

  • fishmanpa
    fishmanpa Member Posts: 1,227 Member
    hawk711 said:

    Sheila and Metro specifically, but questions for all

    Hi All:

    I am 3 years post treatment and am now have huge issues with my jaw.  I think it is teeth related but not sure yet.  Have MRI this week.

    About 3 weeks ago, I had a swollen, infected left jaw.  Believe I had an infection in my Massoteric space (muscle).  ANyway, great pain at this time.  My dentist says pain could have come from a tooth.  All my teeth feel and look o.k. but she said that doesn't matter, it could be the root cause for the infection.  In reading your comments, I think I am having many of the same issues you two have had or are having.  I had no issues for 3 yeasrs and now WHAM, I got big issues.  I also cannot open my jaw more than 1" and was over 2" 4 weeks ago.  Did you all have this issue when you had the teeth issues????   I will try to keep this topic going as I think the teeth are the issue that all the newbies may have in 2-4 years and should be discussing with their doctors now....I'm sure that many who were on the site 3-4 years ago just don't come back to this site and report how they are doing.  I know DLewis and I are the older posters on this site, next to Skiffin and Hondo.

    I'll let you all know what my MRI shows and keep you advised.  My dentist says that HB Chamber may be necessary for me if I need to have teeth extracted too.  

    Live each day happy, all the best,

    steve

    Marketing 101

    "keep this topic going as I think the teeth are the issue that all the newbies may have in 2-4 years and should be discussing with their doctors now...."


    I'm sales and marketing director for the CD/DVD company I work for. Keeping your name or product in front of the customer's eyes is one of the key ways to keep the phones ringing. This is a similar thing and one of the reasons I posted the subject. We all need to be aware of the issues radiation side effects can produce down the line, especially newbies like myself. I knew there could be dental issues but they were kinda glossed over in my case.

    I still need to do some more research into the subject but as Steve stated in the above post, it's something that needs to be in the forefront of our minds as we recover from treatment and move on with our lives. The complications and challenges presented by our future dental health on top of all the other challenges isn't exactly encouraging. The products used are as varied as the advice from dentists. I'd like to see if there are some standard of care type documentation from the ADA concerning dental care for patients that have had radiation of head and neck.

    I'll look further into it and share what I find. 

    "T"

  • MarineE5
    MarineE5 Member Posts: 1,030 Member
    jim and i said:

    Specialist Dentist

    Do you need a Head and Neck cancer dentist? They pulled Jims back teeth and cut off a bridge before treatment, now his remaining teeth are crumbling. We cannot afford a specialist and probably not a regular dentist. Does Medicare cover the removal of teeth?

     

    Debbie

    I found this on line

    Debbie,

    I did a quick search this morning and found this, I am not sure how helpful it is to you, but you can read it.

    http://www.medicareinteractive.org/page2.php?topic=counselor&page=script&slide_id=1591

    I seem to recall someone on here that may have had their Dental work paid for by Medicare, but I forget who it was.

    My Best to You and Everyone Here

  • wrhbounds
    wrhbounds Member Posts: 39
    no teeth +10

    I have not found anyone who has 10 or more years without teeth and jaw issues. Back then most Drs recommended all teeth be pulled before radiation treatment I did not. My treatment hyperfractionated irradiation at 125 cGy twice a day total 7000 cGy it was brutal. I was able to keep my teeth for 8 years then manderbal started to die 6 years & 17 operations latter all teeth removed then fibula flap then implants & dentures. My how time flies when you are having fun