Dental/Necrotic Jaw Problems 30+ yrs Post Radiation and Radical Neck Dissection

madison7133

After recently experiencing extensive dental issues, both my dentist and oral surgeon are concerned the problems are a result of the radiation treatments I received following a modified radical neck dissection. Here’s the kicker – I was 19 years old while a freshman in college when I had the cancer/surgery; I am 51 now – it was 32 years ago. I’d had metastatic lymphoma that spread from my left sub maxillary salivary gland – which was removed as well.
In addition to the ongoing tooth loss I'm just recently experiencing, there are two areas where necrotic bone is “floating” through the gum. It is happening in areas where there has been no tooth loss and the doctors are flummoxed except to theorize it is coming from my mandible because of the past radiation treatments – luckily, I’d had no chemo. I have no jaw pain or problems opening my mouth. During the surgery in 1980, I required transfusions contracting HCV (Hepatitis C). It wasn’t until 2005 that this was discovered and I underwent the standard chemotherapy which I’m happy to say was successful. However, it was immediately following that treatment I started with the dental issues. I’d had no problems with my teeth before.
While I can’t pin this to any one event, I was left with the typical “dry mouth” after the surgery, which in itself could cause these problems or the timing from the HCV chemo. Does this sound familiar to anyone? The expense to correct this will be enormous as it is not covered by insurance and a waste of time/money if there are blood supply problems to the jaw. Any ideas on how to proceed would be appreciated…

Pam M

Wow
Oh my goodness. Very sorry to hear you're experiencing such problems. And thirty two years after treatment, for a side effect like this to show up now - what a blow. Hoping you do not have blood flow problems on top of everything else.

ljoy

Radionucrosis
You will find a lot of people on this site that have had problems post radiation me include. Four years after treatment I had two Jaw teeth come loose on the side I received the most radiation for tonsil cancer. Usually they use pre and post hyberbaric chamber treatment to restore blood flow to the bone and capillaries. I had 30 before surgery and 10 after surgery. I haven't had any further problems in the last three years.

Sorry you are experiencing this after so many years. I would suggest you locate an oral surgeon experienced in the treatment of oral cancers.

Best wishes.

ratface

ljoy said:

Radionucrosis
You will find a lot of people on this site that have had problems post radiation me include. Four years after treatment I had two Jaw teeth come loose on the side I received the most radiation for tonsil cancer. Usually they use pre and post hyberbaric chamber treatment to restore blood flow to the bone and capillaries. I had 30 before surgery and 10 after surgery. I haven't had any further problems in the last three years.

Sorry you are experiencing this after so many years. I would suggest you locate an oral surgeon experienced in the treatment of oral cancers.

Best wishes.

Hyperbaric chamber
as ljoy stated would probably be the best bet. Has anyone talked about it as an option for you?

Tim6003

ratface said:

Hyperbaric chamber
as ljoy stated would probably be the best bet. Has anyone talked about it as an option for you?

Hi Madison...
I can't help with your situation and I sure hope this does not sound as if I am making light of your issues ...but can I say it was a pleasure to see a post from a 32 year survivor?!!! Wow.

I pray the best outcome for your situation...and I'm sorry you are having to deal with this issue so long after the fact.

Best,

Tim

hwt

Tim6003 said:

Hi Madison...
I can't help with your situation and I sure hope this does not sound as if I am making light of your issues ...but can I say it was a pleasure to see a post from a 32 year survivor?!!! Wow.

I pray the best outcome for your situation...and I'm sorry you are having to deal with this issue so long after the fact.

Best,

Tim

Teeth issues
Had my mandible replaced with titanium & fibula in January and finished chemo and rads in May. They took allot of my lower teeth in the surgery. Surgeon said I would need to do that hyper baric pressure chamber before any dental work but not until 6 months after chemo & rads finished. The reconstructive dentist is actually based at the hospital. To date, my health insurance has paid him. He said they should pay for my implants as well. It may make a difference since my teeth were extracted as part of the cancer surgery and not lost as the result of chemo/rads. Have you inquired to the health insurance company?

Kent Cass

hwt said:

Teeth issues
Had my mandible replaced with titanium & fibula in January and finished chemo and rads in May. They took allot of my lower teeth in the surgery. Surgeon said I would need to do that hyper baric pressure chamber before any dental work but not until 6 months after chemo & rads finished. The reconstructive dentist is actually based at the hospital. To date, my health insurance has paid him. He said they should pay for my implants as well. It may make a difference since my teeth were extracted as part of the cancer surgery and not lost as the result of chemo/rads. Have you inquired to the health insurance company?

Teeth, gums and jaw
Others in the past have forewarned us of the possible jaw problems getting severe and requiring surgery some 12-15 years down the road, due to the rads. Just part of the 2nd chance at life. My teeth- by my reckoning I've spent around $6-7K on them, alone, post-tx, and it is all out of pocket for me. Does seem logical that if the rads cause the damage, then the insurance company which paid for the rads should also cover the repair costs for the damage done by them. Same would go for jaw issues down the road, etc. Hope your issues get worked-out in the best ways possible.

kcass