Teeth issues

michdjp
michdjp Member Posts: 220

Hi,

my dad is 4 years post treatment for stage 4a tonsil with chemo and radiation. He has had root canals and shaved some teeth down (so as not to pull them) but tonight his bottom front tooth just fell out.  The dentist we saw here on Staten Island did not recommend the oxygen chamber.  What can I do for this? how can I prevent this from happening to any other teeth? Thank you 

michelle

Comments

  • Duggie88
    Duggie88 Member Posts: 760 Member
    Michelle

    Your Dad should be using prescription tooth paste with fluoride at night before bed. I ended up losing my bottom front four teeth because they rotted from the inside out from the radiation. Three actually broke off on their own all in a short period of time. Because it was the same path as the radiation they wanted me to go through hyperbaric treatments before and after they were pulled.  I was told that even though I didn't use the fluoride toothpaste until after this issue I still would have lost those teeth.

          Jeff

  • michdjp
    michdjp Member Posts: 220
    Duggie88 said:

    Michelle

    Your Dad should be using prescription tooth paste with fluoride at night before bed. I ended up losing my bottom front four teeth because they rotted from the inside out from the radiation. Three actually broke off on their own all in a short period of time. Because it was the same path as the radiation they wanted me to go through hyperbaric treatments before and after they were pulled.  I was told that even though I didn't use the fluoride toothpaste until after this issue I still would have lost those teeth.

          Jeff

    Thank you

    Jeff,

    thank you for your reply, where do you get the toothpaste, the dentist? and did you use the hyperbaric treatments? I hate the sidfee effects from this and it's like none of the doctors really care about the side effects. Anyway thank you for your help.

    michelle

  • ljoy
    ljoy Member Posts: 94
    Teethosteoradionecrosis

    sounds like you may have osteoradionecrosis (dead bone from radiation). I had two lower jaw teeth come loose four years after treatment. My regular dentist did not know what was happening. An oral surgeon new the problem and immediately set me up for HBOT. 30 treatments before surgery and 10 after. The key was to remove the teeth and debrid the dead bone until he reached bleeding bone. HBOT helps circulation to the damaged area. i would suggest you find an oral surgeon expericed in Head and Neck Cancer.

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

    Teethosteoradionecrosis

    sounds like you may have osteoradionecrosis (dead bone from radiation). I had two lower jaw teeth come loose four years after treatment. My regular dentist did not know what was happening. An oral surgeon new the problem and immediately set me up for HBOT. 30 treatments before surgery and 10 after. The key was to remove the teeth and debrid the dead bone until he reached bleeding bone. HBOT helps circulation to the damaged area. i would suggest you find an oral surgeon expericed in Head and Neck Cancer.

    HBOT

    Make sure insurance will cover, extremely expensive. Not painful at all but time consuming, two hours a day Mon-Fri. I was fortunate to have several locations close to home to chose from but that isn't always the case. My remaining teeth are cleaned and checked every 4 months instead of 6. Also an expense since my dental plan only covers cleanings every 6 months. 

  • ratface
    ratface Member Posts: 1,337 Member
    He needs special dental measures

    I see the dentist for a cleaning 4 times a year without insurance and sometimes get a little tired of it but the truth is we need special care. The bottom jaw bone is thicker than the top bone and absorbs more radiation hence our problems  usually manifest  on the bottom. There are two things going on, decreased circulation and decresed saliva. The combination is very harmful. I would suggest a water pick becuase we cannot flush out all those little bits of food which will complicate matters further. After a meal if I use the water pick the entire sink is coated in little bits of food which normally in a healthy saliva producing person would be washed down. He certainly should be using fluoride trays daily. Hyperbaric as mentioned would probably help a lot as well as the debridement. Sounds like he needs some professional work by a dentist familiar with Head and Neck cancer patients. They do exist and are out there.

  • michdjp
    michdjp Member Posts: 220
    ratface said:

    He needs special dental measures

    I see the dentist for a cleaning 4 times a year without insurance and sometimes get a little tired of it but the truth is we need special care. The bottom jaw bone is thicker than the top bone and absorbs more radiation hence our problems  usually manifest  on the bottom. There are two things going on, decreased circulation and decresed saliva. The combination is very harmful. I would suggest a water pick becuase we cannot flush out all those little bits of food which will complicate matters further. After a meal if I use the water pick the entire sink is coated in little bits of food which normally in a healthy saliva producing person would be washed down. He certainly should be using fluoride trays daily. Hyperbaric as mentioned would probably help a lot as well as the debridement. Sounds like he needs some professional work by a dentist familiar with Head and Neck cancer patients. They do exist and are out there.

    Thank you

    Thank you ratface, hwt and ljoy for your responses.  I did contact my ent who told me basically the same things.  It's funny how you guys know just as much and MORE! Thank you.  Dad has been using a water pike for some time now but not the fluoride trays I am going to look into this.  As always, thank you for sharing your advice with me.

    all my best michelle

  • Kent Cass
    Kent Cass Member Posts: 1,898 Member
    michdjp said:

    Thank you

    Thank you ratface, hwt and ljoy for your responses.  I did contact my ent who told me basically the same things.  It's funny how you guys know just as much and MORE! Thank you.  Dad has been using a water pike for some time now but not the fluoride trays I am going to look into this.  As always, thank you for sharing your advice with me.

    all my best michelle

    6+ years of Dental issues

    Sodium Flouride toothpaste is the prescription stuff I get, and is available generic. Flouride trays were advised, but I've opted to just use the toothpaste.

    I've had no teeth fall out, but have had 3 root canals (one needed done twice to get it done), and 6 Crowns- one to replace a Crown that no longer fit good on the stub underneath. And, yes, like ratface said- regular cleaning via Dentist w/quick check is what I do several times/year.

    Big issue for me was the wearing-away of the top-inside on some ten teeth, and which also lead to the shortening of those teeth. My Dentist has some artificial-like tooth substance that he rebuilds those tops with, cures with heat applied, and it lasts for years. Most of those teeth were also developing pits in their tops. Seems like it costs about $60/tooth, but is worth it because without it those teeth would be major problems for me by now- and they are not problems at all for me. He's had to do a couple of them twice, so it doesn't last forever. Something to consider.

    I have been told that it is essential to keep the teeth, as having them pulled would just hasten the jaw problems so many face 10+ years after tx. The bloodflow problem of Osteoradionecrosis is what all of us with major rads to the tooth/jaw area face, long term. My ENT has even agreed that his info is that I can expect full, or more-probable, jaw replacement some 12 years after, so that's only 6 years away for me. And, I have noticed discomfort in my upper-right area when I put even mild pressure against it with my hand, and occasionally in other areas when eating.

    Hope this helps

    kcass 

     

  • michdjp
    michdjp Member Posts: 220
    Kent Cass said:

    6+ years of Dental issues

    Sodium Flouride toothpaste is the prescription stuff I get, and is available generic. Flouride trays were advised, but I've opted to just use the toothpaste.

    I've had no teeth fall out, but have had 3 root canals (one needed done twice to get it done), and 6 Crowns- one to replace a Crown that no longer fit good on the stub underneath. And, yes, like ratface said- regular cleaning via Dentist w/quick check is what I do several times/year.

    Big issue for me was the wearing-away of the top-inside on some ten teeth, and which also lead to the shortening of those teeth. My Dentist has some artificial-like tooth substance that he rebuilds those tops with, cures with heat applied, and it lasts for years. Most of those teeth were also developing pits in their tops. Seems like it costs about $60/tooth, but is worth it because without it those teeth would be major problems for me by now- and they are not problems at all for me. He's had to do a couple of them twice, so it doesn't last forever. Something to consider.

    I have been told that it is essential to keep the teeth, as having them pulled would just hasten the jaw problems so many face 10+ years after tx. The bloodflow problem of Osteoradionecrosis is what all of us with major rads to the tooth/jaw area face, long term. My ENT has even agreed that his info is that I can expect full, or more-probable, jaw replacement some 12 years after, so that's only 6 years away for me. And, I have noticed discomfort in my upper-right area when I put even mild pressure against it with my hand, and occasionally in other areas when eating.

    Hope this helps

    kcass 

     

    Thank you

    I can't say it enough, side effects are sooo unfair! Wasn't getting thru treatment and living a new normal enough! I feel like there are no good options  when it comes to the teeth.  My dad is so afraid to eat anything hard for fear of any more coming out and he to has pain while eating. It's  so unfair. Sorry for venting. Thank you for all your advice and taking the time to share it. This August 11, will be 4 years and I am so greatful. I wish you continued healing.

    all my best michelle

  • slk2015
    slk2015 Member Posts: 54
    teeth

    I did not have chemo or radiation.  However, my teeth were breaking off at the root long before the cancer surgery.  I have oral lichen planus and a very dry mouth.  I use the dentist prescribed flouride toothpaste, plus dry mouth toothpaste.  Currently, I am missing three front teeth.  Eating has been a challenge for the last 10 years or so.  After losing about a quarter of my tongue to the cancer surgery, I now have phantom pain which makes eating difficult also.  My husband sometimes makes three or four things before I find something I can eat.  He usually asks if my mouth can "take" eating a certain food before trying one.  I'm not always good at judging what I can handle, however.  I get very cranky when I'm hungary and it hurts so bad to eat.  I can't skip meals because I'm a type 1 diabetic.  Later this year, I am having my top teeth pulled and going to a denture to see if that will help.  This is just to let you know that you're not alone in the breaking teeth and the frustrations with eating.  All of us deal with what we are dealt as best we can.  

  • Mylife2017
    Mylife2017 Member Posts: 2
    Teeth issues

    i don't know what's worst, the painful ulcers I still have in my mouth and tongue since radiation for tonsil cancer. Or my teeth breaking!  I felt alone until signing on to this site.  Thank you for sharing.  It helps knowing I'm not alone in my battle with my breaking teeth