Do I need HBO for an apicoectomy?


Hi, I'm 48 and when I was 28 had thyroid cancer. It actually was diagnosed when I was 19 (5lbs bilateral). Extracted and came back when I was 28 because an internist took me off thyroid for 6 months. Was given i131 and beam radiation in October 1994:

Treatment site                                                                  total dose

Oropharynx, bilateral necks, R/L lateral                                  6840 cGY

Bilateral Supraclav area, AP                                                5040 Cgy


R/L Lateral Posterior neck electron enface fields                     1000 cGy


Since then I've been cancer free. Have had no major problems except I can't filter out smells like cigarette smoke or perfume well. Haven't needed antibiotics in 2 years. I'm a strong guy with no bone loss in my jaws and good gums. 

But I'm having a dental problem. I had a root canal in 2009 then another retreat on the same tooth (upper left 2nd from back) and still there's a spot that looks infected to the endo. Did not have pain but dentist kept a temp cap on that tooth for 6 months because he kept messing up, blaming the cast. I can open my mouth about 2 1/2 fingers, so not the 3 that is normal, but usually enough for dentist to work on.

Anyway, in the midst of all this the area has become on and off sensitive and my endodontist said it's time to get an Apicoectomy and although he has no experience with cancer patients doesn't think it will give me any problems. I was worried and went to a radiologist-oncologist for a consultation. He told me there was a small chance of orn, but given the area (top) and the fact that I'm healthy, it was unlikely. He also suggested I go to MD Anderson to have them check into it. Well, I can't get in. I haven't had cancer in a long time and they consider me cured. One endocrinologist said it was unlikely cancer would return. 

So, I read all about ORN, necrosis, slow healing, Pre and post surgery HBO and I'm scared. I don't know who to believe. I have a wife and a 5 year old daughter. I'm in good health otherwise but I'm terrified. Never had a broken bone, let alone ORN. My teeth feel solid and I take good care of them. What should I do? 

Thanks for any suggestions.




  • ljoy
    ljoy Member Posts: 94
    Orn - HBO


    I’m a nine year survivor of tonsil cancer. Had ORN and HBO four years after treatment. I had a right lower jaw tooth loose. X-ray revealed dead bone (ORN). My regular dentist did not know what was causing the problem. He referred me to an endodontic specialist. He determined it was not a root problem and I needed an oral surgeon. Fortunately we have oral surgeons who treat head and neck cancer patients on a regular basis. My HBO and oral surgery were successful and I have had no problem since. I have had routine fillings and a crown with no problem.


    A dentist or oral surgeon experienced with head and neck cancer treatment should be able to identify ORN. Even I could see the change in the bone on the x-ray.


    It sounds like your teeth are in good condition other than the one tooth. It appears you do not have any signs or symptoms of ORN. I would suggest you seek a second opinion with an oral surgeon who has experience with head and neck cancer patients. Your radiation oncologists should be able to recommend someone.


    Keep us posted on your progress. My best wishes to you and your family.


  • lorig01
    lorig01 Member Posts: 83
    Are you in Houston?

    Hi. Are you in Houston? If yes, let me know. I can recommend a dentist that interned at MD Anderson and sees several head and neck patients, (including myself). She also lectures to dentists in Houston about working on head and neck cancer patients.  I am sure she can give you an informed opinion.

  • debbiejeanne
    debbiejeanne Member Posts: 3,102 Member
    i can't answer any of your

    i can't answer any of your questions but wanted to second the notion for a second opinion.  i'd see a surgeon/dentist who has experience with H&N cancer.  praying that you are able to find what you need and that all is fine and nothing needs to be done.  let us know how you do.

    God bless you,