Dental problems long term

HWU

Good Morning, 

Newbie here to this site. Lol! Haven't said that for awhile since I'm 58. Anyway, I was diagnosed with base of tongue cancer in 2011. Went through 44 treatments of radiation to the head and neck. Now going on 5 years since, my teeth and gum problems are still a very important part of my day. The pain is at times unbearable. I still take morphine twice a day and Oxy as needed for the pain. It generates on the left side below the ear and radiates along the jaw line up to and past the right ear. The pain meds do not take the pain away completely but they reduce the pain to a 5-7 on a scale of 10. I am not a candidate for hyperbaric procedures because of the problems I've had with my ears in the past. 

So....what am I doing here? Looking for options for my teeth. They were not the best before treatment but they were not the worst either. I mean they were not " Hollywood" ....all bright white straight level... But they were ok. I have had 12 root canals, 5 ground down to the gums, 7 fillings and I do not know how many are beginning to decay as of today. 

So...what are other people doing.... Dentures? Implants? Veneers?. I was told that I could not have any pulled as the hole in the gum would never heal and infections would happen. 

Any advice or options would be greatly appreciated, because it seems that I am starting to get concerned about what lies ahead in regards to eating. 

Mikemetz

Can you say "Prothodontist"?

I am just starting the process of replacing the several teeth I've lost since being diagnosed and treated in 2009.  I had a jaw resection on the left side, so every step of this has to be "custom done" even more than the usual individual design and installation of implants, dentures, etc.  From my oral surgeon's advice, I am seeing a prothodontist who has a lot of experience with jaws like mine.  Those two docs have worked together a lot.

Bottom line, before you start to ask questions about what to do, be sure that you have a dentist with lots of experience with radiated bone and other issues that come from those treatments--and who will work with your onco doc closely.

Even if you ask the right questions, if you ask them to the wrong kind of doctor, it can turn out badly.

mike

 

 

Barbaraek

Mikemetz said:

Can you say "Prothodontist"?

I am just starting the process of replacing the several teeth I've lost since being diagnosed and treated in 2009.  I had a jaw resection on the left side, so every step of this has to be "custom done" even more than the usual individual design and installation of implants, dentures, etc.  From my oral surgeon's advice, I am seeing a prothodontist who has a lot of experience with jaws like mine.  Those two docs have worked together a lot.

Bottom line, before you start to ask questions about what to do, be sure that you have a dentist with lots of experience with radiated bone and other issues that come from those treatments--and who will work with your onco doc closely.

Even if you ask the right questions, if you ask them to the wrong kind of doctor, it can turn out badly.

mike

 

 

Wise advice Mike...

And one for us to keep in mind, since radiation seems to be the gift the keeps on giving with regard to jaw and dental issues. Glad your dentist knew a good person to send you to.

Barbara

HWU

Mikemetz said:

Can you say "Prothodontist"?

I am just starting the process of replacing the several teeth I've lost since being diagnosed and treated in 2009.  I had a jaw resection on the left side, so every step of this has to be "custom done" even more than the usual individual design and installation of implants, dentures, etc.  From my oral surgeon's advice, I am seeing a prothodontist who has a lot of experience with jaws like mine.  Those two docs have worked together a lot.

Bottom line, before you start to ask questions about what to do, be sure that you have a dentist with lots of experience with radiated bone and other issues that come from those treatments--and who will work with your onco doc closely.

Even if you ask the right questions, if you ask them to the wrong kind of doctor, it can turn out badly.

mike

 

 

Prosthodontist suggestion

Funny you have mentioned that, because my dentist and I are actively searching for one as we speak in or around the area we live. Since I'm retired traveling to one of the best in the field is not a problem. I'm sure once we find one and proceed (and every case is different) I was wondering what "someone" or anybody would choose, implants, dentures, or any other procedure which might be available. Have you chosen a procedure yet? Implants? Dentures? I assume your gums and jaw are painful. Has the "Prosthdontist" informed you about possibly reducing or eliminating the pain with options say....dentures vs implants. 

Thanks for your time.

Hondo

HWU said:

Prosthodontist suggestion

Funny you have mentioned that, because my dentist and I are actively searching for one as we speak in or around the area we live. Since I'm retired traveling to one of the best in the field is not a problem. I'm sure once we find one and proceed (and every case is different) I was wondering what "someone" or anybody would choose, implants, dentures, or any other procedure which might be available. Have you chosen a procedure yet? Implants? Dentures? I assume your gums and jaw are painful. Has the "Prosthdontist" informed you about possibly reducing or eliminating the pain with options say....dentures vs implants. 

Thanks for your time.

Welcome to CSN H&N

Teeth

I have always done my best to take care of my teeth, so going into treatment nothing needed to be done. Now 14 years later I can’t open my jaw far enough to brush them and no dentist will touch me for fear of making things worse. So I do what I can with what I have, I use an Oral b sonic toothbrush and my daughter make me my own toothpaste; that has been doing a wonderful job at keeping the teeth clean and keeping out infection.

 

Tim

SASH

Teeth

It is possible to have teeth removed.  This probably will require Hyperbaric Oxygen Treatments before and after they remove teeth.

I was in this boat last year as I was down to 4 front lower teeth.  I saw a Maxillary Oral surgeon who said he could help.  This was the process to get the work done.

30 Hyperbaric Oxygen Treatments of 90 minutes under pressure

Surgery to remove remaining teeth and file down lower jaw to prepare for implant posts

Installation of implant posts

10 Hyperbaric Oxygen Treatments to help with the healing process

6-7 months of healing

Next step is to uncover the implant posts and then have a partial lower implant that will include 10 lower teeth which will match my upper bite.  Because I'm healing so well, the uncovering of the implants is being done after 5 months.  Then a week later they will hopefully start the process of impressions to make the lower implant.

 

Kent Cass

SASH said:

Teeth

It is possible to have teeth removed.  This probably will require Hyperbaric Oxygen Treatments before and after they remove teeth.

I was in this boat last year as I was down to 4 front lower teeth.  I saw a Maxillary Oral surgeon who said he could help.  This was the process to get the work done.

30 Hyperbaric Oxygen Treatments of 90 minutes under pressure

Surgery to remove remaining teeth and file down lower jaw to prepare for implant posts

Installation of implant posts

10 Hyperbaric Oxygen Treatments to help with the healing process

6-7 months of healing

Next step is to uncover the implant posts and then have a partial lower implant that will include 10 lower teeth which will match my upper bite.  Because I'm healing so well, the uncovering of the implants is being done after 5 months.  Then a week later they will hopefully start the process of impressions to make the lower implant.

 

Ditto to SASH

Like Delnative in years past, for your issue I would consider SASH as the authority on the matter, here. Thing is, I hope you have good insurance, as the $ for this is gonna be large. If you cannot go thru Hyperbaric, then that might limit your options, though that's only a guess. Do know Hyperbaric is a standard everybody uses, now. 

Your Dr. should be dealing with this with a solution planned that does not include Morphine. Longterm use of Morph is not an acceptable solution, unless you want to be a definitive drug addict, and your Dr. knows that. I used Morph for 4 of 5 consecutive weeks, and Hydrocodone helped me to ween off of it. Please be aware of the hazard that Morph can be.

I, too, was told I couldn't have a tooth pulled, but it was shortly after tx. Instead, Root Canal and Crown was the answer. For all of us who got extensive rads to the mouth area, Osteoradionecrosis is something we'll likely be dealing with at some point down the road. SASH is a longterm survivor, compared to the almost 7-year survivor I am. My Dentist has direct ties to the U of Iowa, which has a noted Dental School, and we're monitoring my gums/teeth and jaw condition as best we can- which included a recent Root Canal and new Crown on a tooth with signs of deterioration in the tooth body, which is now corrected.

Best of luck going forward. They don't warn us, going-in, about all the damage tx can cause, but this be one of them.

kcass

hawk711

Kent Cass said:

Ditto to SASH

Like Delnative in years past, for your issue I would consider SASH as the authority on the matter, here. Thing is, I hope you have good insurance, as the $ for this is gonna be large. If you cannot go thru Hyperbaric, then that might limit your options, though that's only a guess. Do know Hyperbaric is a standard everybody uses, now. 

Your Dr. should be dealing with this with a solution planned that does not include Morphine. Longterm use of Morph is not an acceptable solution, unless you want to be a definitive drug addict, and your Dr. knows that. I used Morph for 4 of 5 consecutive weeks, and Hydrocodone helped me to ween off of it. Please be aware of the hazard that Morph can be.

I, too, was told I couldn't have a tooth pulled, but it was shortly after tx. Instead, Root Canal and Crown was the answer. For all of us who got extensive rads to the mouth area, Osteoradionecrosis is something we'll likely be dealing with at some point down the road. SASH is a longterm survivor, compared to the almost 7-year survivor I am. My Dentist has direct ties to the U of Iowa, which has a noted Dental School, and we're monitoring my gums/teeth and jaw condition as best we can- which included a recent Root Canal and new Crown on a tooth with signs of deterioration in the tooth body, which is now corrected.

Best of luck going forward. They don't warn us, going-in, about all the damage tx can cause, but this be one of them.

kcass

Hey Sash

So happy to see your tooth issue being corrected.  I've been reading your posts for 6 years and you are the definite pioneer of the group.  Please keep us posted on your progress, maybe even a photo ! 

We will all have teeth issues of some degree.  Non of us know the degree and any info from a more experienced warrior can be of great help to us all.

All the best Sash,

Steve

SASH

hawk711 said:

Hey Sash

So happy to see your tooth issue being corrected.  I've been reading your posts for 6 years and you are the definite pioneer of the group.  Please keep us posted on your progress, maybe even a photo ! 

We will all have teeth issues of some degree.  Non of us know the degree and any info from a more experienced warrior can be of great help to us all.

All the best Sash,

Steve

What my new teeth will look like it

I have my profile picture set to what I want my new teeth to look like.  I think it will be great to finally be able to eat anything and everything again.  LOL

caffinated1

Hondo said:

Welcome to CSN H&N

Teeth

I have always done my best to take care of my teeth, so going into treatment nothing needed to be done. Now 14 years later I can’t open my jaw far enough to brush them and no dentist will touch me for fear of making things worse. So I do what I can with what I have, I use an Oral b sonic toothbrush and my daughter make me my own toothpaste; that has been doing a wonderful job at keeping the teeth clean and keeping out infection.

 

Tim

I bought a aqua pic, that is

I bought a aqua pic, that is the best food getter outer I've used yet. Set the pressure to medium and nothing can hide between your teeth and upper gum line. Brush with the prescription floride tooth paste using a sonic care tooth brush....big help.

slk2015

I didn't have radiation, but as I posted in another thread, tooth extractions on the right side of my face where the glossectomy and lymph node removal were done don't heal properly for weeks.  I have had to have narcotic pain reliever twice now (short term), for 8 extractions and then 2.  I have teeth on the bottom that my dentist wants out, but I have to figure out how to deal with the slow healing, swelling, etc before we proceed.  One of the last 2 became a dry socket. I needed antibiotics after both extractions.

I went with dentures. Not because of the cost, but because I can take them out of my mouth.  After surgery on my tongue and years of abcesses and other tooth problems, I wanted something that if it hurt, it could be removed.  

It is tricky learning to eat with the dentures.  I didn't go with immediate dentures, so for four months, I went without.  Now I have to relearn how to chew, how to not bite my check and tongue, etc.  Lack of saliva doesn't help.  But I'd make the same choice even looking at what I having to relearn because I am so happy to be able to pull them out if they hurt.

This is just me--it may not apply to others.  I simply got tired of my mouth being my enemy and went with the solution that gave me the most control.

David m

Dentures and bad teeth, 10 yrs post oral cancer?

I still have most of my teeth and 9 1/2 yrs after my radiation/ chemo. I have spent a lot on keeping my teeth, I did have two uper molars pulled a week ago, without HBO. and so far so good. I read an article that stated HBO is only needed once in your life, I had the flap resection in 2011, and had a very bad infection, and was on HBO/ pick line antibiotics 4hrs a day. But I was told By the UCLA Dentist, that they will pull the upper teeth without the HBO. I had not heard this before. but a week afterwards and it seams to be healing up my teeth were not really great before this all started in 07, with the many surgeries and 08 was more surgeries, and the chemo/ radation. I came back here to recearch Dentures, and am not likeing the problems I hear about them. On my bottom they decapitated 2 molors  about a yr ago and now I may have 2 more cut off. without dental ins, and waithing for disabilaty pay to be approved, living off my IRA. It would be nice to get some good quality dental done FREE, but at this time the only Dentist I really trust are at UCLA. Thats where most of my cancer surgeries were done.