Tooth removed today POST radiation

wifeforlife

ljoy said:

Loose Teeth
I had a tooth come loose this time last year. Thankfully had an oral surgeon who new the damage caused from radiation for tonsil cancer. Went to Hennepin county Medical Center for 40 HBO treatments before extraction of two teeth. It was definately worth the time to make sure the bone and tissue would heal after surgery. Since you mentioned you were at the U of MN I thought you might want to check out Hennnepin County Medical Center.

The teeth came loose because the blood supply is not suffient to keep the teeth alive. The bone is also damaged and needs to be debrieded (sp) in order to heal properly.

Hope all turns out well for you.

update
an interesting piece of information... the "pre" HBO treatments last a life time. If he needs any further invasive procedure he will only need to take the "post" HBO treatments.

As of today we do not have any throbbing pain and he is off pain meds. Which means we do not have a dry socket. He is using his rinse with syringe everytime he puts anything in his mouth (except water)
I check it with a light twice a day..he can't see it because it was a back tooth and his jaw doesn't open as wide as it use to ...

wifeforlife

backachedp said:

Thank you
I agree...time is limited so we will have to figure this out quickly as his teeth are so bad they are so loose he said he could almost pull them out himself;( He has been getting Vicodin, but it just is not cutting the pain...it's so frustrating as he has enough trouble ating and after his last Apt. he said they hammered on all of his teeth and has only been able to eat soup's and oatmeal...when he was at the ENT yesterday he was in the room waiting for the Dr and a Woman came in and said "Hi I am a speech Therapist"..they told me you were drooling when you came in! He said lady I have lost my saliva glands I wish I could DROOL!..this Cancer just keep's on giving...but thankfully it is GONE. The after effect's are different for everyone and Bob has so much trouble eating..choking..they scope him and say all is well. He did loose his swallow during Treatment, so it is so important not to loose your swallow as I belive some of all the issues of eating etc are because of tgis..maybe I am wrong. He is working 20 hours a week now and it is kicking his Butt, but it is a start after not working for 18 months. Everyone here is so kind and helpful I so appreaciate that...it makes a person know they are not alone and so many have been thru the smae thing.

backachedp
I really feel like you should see someone who knows what they are dealing with. To simply make sure that ALL of those teeth need to be removed. The removal of the teeth is not the problem, that is easy takes 1 min per tooth... it is the damage that the radiation has done to the bone that is the issue and when you pull the teeth it exposes the bone and healing is an issue. It is called Osteonecrosis of the Jaw or you can get inforomation on it online under BOT (this is actually caused by something else...but it is the same thing.) The condition is almost like Gangrene only of the bone instead of the flesh. If this occurs the bone needs to be removed.
I understand that he is in pain... but please see someone informed
Wife

fisrpotpe

wifeforlife said:

update
an interesting piece of information... the "pre" HBO treatments last a life time. If he needs any further invasive procedure he will only need to take the "post" HBO treatments.

As of today we do not have any throbbing pain and he is off pain meds. Which means we do not have a dry socket. He is using his rinse with syringe everytime he puts anything in his mouth (except water)
I check it with a light twice a day..he can't see it because it was a back tooth and his jaw doesn't open as wide as it use to ...

Keep on
Keep on keeping it clean. Great job and good news about the lack of pain.

Thanks for the update.

John

sportsman

sweetblood22 said:

Good subject for the Superthread. Thank you.
You are right that is something good to add to the Superthread. I have not been through it so I cannot really answer your question. I may have to have one pulled without the HBO. Just the thought makes me sick. From the limited discussion I had with my dentist you should heal up fine with having HBO treatments.

I will be watching for answers here as well.

Teeth being Pulled
Sweet: I had a crown today and my dentist was having a hard time putting in the crown because he said I had a tooth that had dropped and was in the way of the crown being put in. He said that this tooth that was giving him the problem was not really serving me a purpose so far as to make a contact to bite. He said it probably should be pulled but decided to do a little grinding on it inorder to make the new crown on another tooth work. I have read so much on here about not healing when having a tooth pulled that it scares me to death. He advised that the area could not possibly heal and cause you to lose part of your jaw bone. He is trying to keep me in a position where I will not lose a tooth. He did advise that if this happened he would refer me to a oral surgeon who is more familar in handling cases associated with the radiation of head and neck cancer. My radiation treatment ended now just over four years ago. I have had several crowns and several fillings. In reading your postings on here it appears you are having many of the same problems I am having with teeth. I personally neglected mine for a number of years when I was very young but had them in decent shape before radiation. With all the other terrible side effects from radiation that has happened to me it wold be devastating to lose my teeth. I would appreciate your reply and your thoughts or any others on here. God Bless

backachedp

sweetblood22 said:

Bob definitely wants to have
Bob definitely wants to have only an experienced oral surgeon or maybe dentist pull those teeth. My dentist had me go outside his hospital to some one he knew was the best when I had the ones pulled before radiation. The person he referred me to, my insurance would not cover it. I paid out of pocket because I knew if Dr. Halupa said that was where he felt I should go, and not his colleague in his own hospital, then that was a no brainer for me. Dr. Halupa is the only one who touches my teeth except for the lady who cleans them. He always comes in and checks them even when it's just a cleaning. He is the only one to drill them. He allows the ladies to fill them, but then he always checks their work. He has asked me if I would allow students to observe and learn because of all my issues. He does all the work. He was also the dentist on my tumor board.

I don't have any info about the teeth pulling after rads yet. It will be a while. I guess I got my first cold in over two years. I feel like crud.

The Superthread should be on the first page. It says:


HNC Superthread. A COLLECTION OF HELPFUL LINKS ONLY. (please post only informative links here) Help for some FAQ

sweetblood
Thanks for all the info and help you have given me..and all you other kind and caring people here...I am going to discuss all of this with the U of MN Monday...I will NOT let them touch Bob unless we mostly I am comfortable with all of this..it's alot to think about. I am worried about loss of bone and healing...and Infection...I did find the Superthread thanks so much hope everyone has a great weekend and Sweetblood hope you feel better SOON. 2 years without a cold is great, but I am sure you feel like crap...fluids and rest..but you know that be well
Deb

sweetblood22

backachedp said:

sweetblood
Thanks for all the info and help you have given me..and all you other kind and caring people here...I am going to discuss all of this with the U of MN Monday...I will NOT let them touch Bob unless we mostly I am comfortable with all of this..it's alot to think about. I am worried about loss of bone and healing...and Infection...I did find the Superthread thanks so much hope everyone has a great weekend and Sweetblood hope you feel better SOON. 2 years without a cold is great, but I am sure you feel like crap...fluids and rest..but you know that be well
Deb

Thanks for the well wishes,
Thanks for the well wishes, Deb. Yes, the possibility with what can happen after those teeth are pulled warrants plenty of research and working with the people who know best. Don't be afraid to wait to find them.

wifeforlife

wifeforlife said:

backachedp
I really feel like you should see someone who knows what they are dealing with. To simply make sure that ALL of those teeth need to be removed. The removal of the teeth is not the problem, that is easy takes 1 min per tooth... it is the damage that the radiation has done to the bone that is the issue and when you pull the teeth it exposes the bone and healing is an issue. It is called Osteonecrosis of the Jaw or you can get inforomation on it online under BOT (this is actually caused by something else...but it is the same thing.) The condition is almost like Gangrene only of the bone instead of the flesh. If this occurs the bone needs to be removed.
I understand that he is in pain... but please see someone informed
Wife

Update
well the pain is gone... gums are still pink... the cavity where the tooth was is still bleeding at times... 6 more HBO treatments...
He is back to eating just about everything as before except some meats.

wifeforlife

wifeforlife said:

Update
well the pain is gone... gums are still pink... the cavity where the tooth was is still bleeding at times... 6 more HBO treatments...
He is back to eating just about everything as before except some meats.

Update
We thought we were going to get through all the HBO treatments without any of side effects they tell you about.
But... his eyes are being affected.Interesting enough... he no longer needs reading glasses...but everything past that is really blurry... difficult fo rhim to see tv or drive. They tell him this is temporary, aparently the preasure of the chamber changes the shape of your eyes but they will go back.
Other than that all is still going well. tooth still bleeding off and on. He has 5 treatments left.

fisrpotpe

wifeforlife said:

Update
We thought we were going to get through all the HBO treatments without any of side effects they tell you about.
But... his eyes are being affected.Interesting enough... he no longer needs reading glasses...but everything past that is really blurry... difficult fo rhim to see tv or drive. They tell him this is temporary, aparently the preasure of the chamber changes the shape of your eyes but they will go back.
Other than that all is still going well. tooth still bleeding off and on. He has 5 treatments left.

Very True
Yep some have their eye sight change. It will come back to what it was.

So good to hear that treatments are going well and wow only five left.

Love the good news.

John

sweetblood22

fisrpotpe said:

Very True
Yep some have their eye sight change. It will come back to what it was.

So good to hear that treatments are going well and wow only five left.

Love the good news.

John

Wife, wanted to thank you
Wife, wanted to thank you for the updates. I have been trying to find articles all day on tooth extractions for HNC patients post rads with no HBOT. Not finding anything useful. I found one paper that looked very promising, but it was restricted. I did come across some good articles on necrosis and dental protocol for HNC patients that I will update the Superthread with.

If anyone else has info or experience with getting a tooth pulled after rads, with no HBOT I would love for you to share that with me.

Thanks,

Sweet

ratface

sweetblood22 said:

Wife, wanted to thank you
Wife, wanted to thank you for the updates. I have been trying to find articles all day on tooth extractions for HNC patients post rads with no HBOT. Not finding anything useful. I found one paper that looked very promising, but it was restricted. I did come across some good articles on necrosis and dental protocol for HNC patients that I will update the Superthread with.

If anyone else has info or experience with getting a tooth pulled after rads, with no HBOT I would love for you to share that with me.

Thanks,

Sweet

having one pulled as I type
Hi Sweet, I mentioned it to you prior to the procedure beginning and was reluctant to say anything further because both my dentist and I weren't really sure it was going to work. He had only read about it. It also took three appointments to set everything up and weekly appointments thereafter to monitor progress. You have to weigh this with daily HBO treatments. Anyway my dentist has a wire spring gizmo hooked up to an adjacent tooth which is attached in an arc to the tooth being pulled. Attached to this there is an orthodontic rubber band attached pulling up in a constant state of tension. I'm on week three now and the tooth is very slowly moving up and I can feel it loosenning. It rose to the point where he had to shave off the top on my last visit to keep the bite correctly alighned. The jury is still out and this could take from 5-6 weeks to work. Hoping it does. I 'll update when the tooth is out.

wifeforlife

ratface said:

having one pulled as I type
Hi Sweet, I mentioned it to you prior to the procedure beginning and was reluctant to say anything further because both my dentist and I weren't really sure it was going to work. He had only read about it. It also took three appointments to set everything up and weekly appointments thereafter to monitor progress. You have to weigh this with daily HBO treatments. Anyway my dentist has a wire spring gizmo hooked up to an adjacent tooth which is attached in an arc to the tooth being pulled. Attached to this there is an orthodontic rubber band attached pulling up in a constant state of tension. I'm on week three now and the tooth is very slowly moving up and I can feel it loosenning. It rose to the point where he had to shave off the top on my last visit to keep the bite correctly alighned. The jury is still out and this could take from 5-6 weeks to work. Hoping it does. I 'll update when the tooth is out.

Update
Sweet.. I wish I could help you..
Ratface... I sure hope this works for you...very interesting.. keep us updated!!!!
UPDATE:
One HBO tratment left... bleeding has stopped and dare I say the hole looks to be getting smaller.... eyes are still bad... but all seems to be going well!
We get a CT on the 24th.. (one yr!!!!) we will see if this has created any other issues!
Wife

sweetblood22

wifeforlife said:

Update
Sweet.. I wish I could help you..
Ratface... I sure hope this works for you...very interesting.. keep us updated!!!!
UPDATE:
One HBO tratment left... bleeding has stopped and dare I say the hole looks to be getting smaller.... eyes are still bad... but all seems to be going well!
We get a CT on the 24th.. (one yr!!!!) we will see if this has created any other issues!
Wife

Ratface
Thank you, Rick. HBOT aren't an option for me unless my Medicaid, which kicks in July I believe, would pay for it. There is no way I could afford it. In my research I think I came across that denistd's Medicaid paid for HBOT so I may PM him to find out about that. I am still getting restoration work done on my teeth and he did fix up 19 for me, and knock wood, so far so good. Hope it hold out. My detist told me that the HBOT wouldn't be something to do for just one tooth, that he would do the rest of the restoration and see if there are any other issues. Hope there aren't.

Thanks for keeping me updated. I really appreciate it. Hope this works for you.

wifeforlife

sweetblood22 said:

Ratface
Thank you, Rick. HBOT aren't an option for me unless my Medicaid, which kicks in July I believe, would pay for it. There is no way I could afford it. In my research I think I came across that denistd's Medicaid paid for HBOT so I may PM him to find out about that. I am still getting restoration work done on my teeth and he did fix up 19 for me, and knock wood, so far so good. Hope it hold out. My detist told me that the HBOT wouldn't be something to do for just one tooth, that he would do the rest of the restoration and see if there are any other issues. Hope there aren't.

Thanks for keeping me updated. I really appreciate it. Hope this works for you.

Update
Husband gum has a small white spot on it where the tooth use to be ... the rest is still pink. Not worried about this yet, just wanted all to know what was happening.

Sweet, most of the people taking the HBO treatments with my husband (they have more than one chamber) are either on medicare or medicaid. The pulmanary DR. is the one that orders it, your dentist will send you there, it is considered medical not dental. The Pulmanary DR told us it is now considered standard treatment for Head and Neck Cancer issues. Wasn't a problem getting it approved at all.
Wife

fisrpotpe

wifeforlife said:

Update
Husband gum has a small white spot on it where the tooth use to be ... the rest is still pink. Not worried about this yet, just wanted all to know what was happening.

Sweet, most of the people taking the HBO treatments with my husband (they have more than one chamber) are either on medicare or medicaid. The pulmanary DR. is the one that orders it, your dentist will send you there, it is considered medical not dental. The Pulmanary DR told us it is now considered standard treatment for Head and Neck Cancer issues. Wasn't a problem getting it approved at all.
Wife

Unknown
I would can the white spot an unknown and call the oral surgeon for some input.

I would also rinse out and then look again. Use the suringe to rinse.

My best guess this is nothing to worry about and part of the extremely slow healing.

John

sweetblood22

fisrpotpe said:

Unknown
I would can the white spot an unknown and call the oral surgeon for some input.

I would also rinse out and then look again. Use the suringe to rinse.

My best guess this is nothing to worry about and part of the extremely slow healing.

John

HBOT with Medicaid or
HBOT with Medicaid or Medicare.

Well, if that is the case, then I am feeling a little less panic about possibly loosing that tooth. I haven't got a clue how Medicaid works or what it will pay for when I get it. It won't kick in until July for me. Right now I am on an uncompensated care program through my hospital and my necessary health care is covered.

My dental is not considered necessary, so I am basically draining what little savings I had left.

Glenna M

sweetblood22 said:

HBOT with Medicaid or
HBOT with Medicaid or Medicare.

Well, if that is the case, then I am feeling a little less panic about possibly loosing that tooth. I haven't got a clue how Medicaid works or what it will pay for when I get it. It won't kick in until July for me. Right now I am on an uncompensated care program through my hospital and my necessary health care is covered.

My dental is not considered necessary, so I am basically draining what little savings I had left.

Sweet
Your Medicaid coverage depends on your income. I am on a spenddown program, before I started receiving my disability I had a $600 per month spenddown. Now that I am getting my disability each month my spenddown went up to $2048 per month. It's really a confusing program but it's better than not having anything. What this means is I have to have $2048 in medical bills before they pay. When I was in treatment this was all well and good, now that I am only seeing my ENT every 2 months and a scan every 3 months I am paying a lot more on my medical bills.

Like you, I have no dental insurance and don't know what I'll do if I need dental work. Money is super tight right now as I am on payment plans with all of my doctors and can't afford to add dentist's bills.

Somehow we will survive, we always do

Stay well,
Glenna

sweetblood22

Glenna M said:

Sweet
Your Medicaid coverage depends on your income. I am on a spenddown program, before I started receiving my disability I had a $600 per month spenddown. Now that I am getting my disability each month my spenddown went up to $2048 per month. It's really a confusing program but it's better than not having anything. What this means is I have to have $2048 in medical bills before they pay. When I was in treatment this was all well and good, now that I am only seeing my ENT every 2 months and a scan every 3 months I am paying a lot more on my medical bills.

Like you, I have no dental insurance and don't know what I'll do if I need dental work. Money is super tight right now as I am on payment plans with all of my doctors and can't afford to add dentist's bills.

Somehow we will survive, we always do

Stay well,
Glenna

Spend down? Good grief. I
Spend down? Good grief. I have no clue about any of this. I am going to have to try and read about this stuff again. I just don't understand it. I will apply for the hospital program again, I think I can. Its up in May, hopefully I can get approved again.

wifeforlife

sweetblood22 said:

Spend down? Good grief. I
Spend down? Good grief. I have no clue about any of this. I am going to have to try and read about this stuff again. I just don't understand it. I will apply for the hospital program again, I think I can. Its up in May, hopefully I can get approved again.

all true
the meicaid spend down is kind of complicated... it's based on your income and expenses... they can tell you at the medicaid office.
Sweet. Keep in mind the HBO will be medical not dental. I know that isn't perfect but at least it is something.

Lisa-NasalPharynx

wifeforlife said:

all true
the meicaid spend down is kind of complicated... it's based on your income and expenses... they can tell you at the medicaid office.
Sweet. Keep in mind the HBO will be medical not dental. I know that isn't perfect but at least it is something.

This dental stuff freaks me out
I surely wasn't prepared for all these AFTER side effects. Do you mean that for the rest of my life I will have issues with my jawbone and teeth? I consulted with my dentist before starting radiation, and he did fix a couple small problems I had, and prescribed the fluoride treatments, but I didn't know about that bone necrosis stuff. And this lasts forever now that I've had radiation?

Geez - - - I went into this with my head in the sand, I guess. When you're first diagnosed, you just want to start treatment and stop the cancer. Bing! Bang! Boom! But, even if I had known these things, I'd still have gone for the treatment. What alternative do you really have?