Tooth Issue Bone & Gum Pocket

Bunnymom

I'm looking for some advice and wonder if anyone can help?

I am 2 years post treatment. Prior to treatment, I was advised to have a wisdom tooth removed on the radiation side which I did. About a month ago, my dentist advised me that I needed a crown on the last, back molar just in front of where I had the wisdom tooth extracted. When she started to work on the crown, she discovered that I needed a root canal and sent me over to the endontist for an immediate root canal. While all this is going on, they discovered a defect because the bone did not fill in very much in the space left where the wisdom tooth was extracted. Plus I have an open gum pocket there as well. 

I saw an oral surgeon who referred me to the University of Chicago and I'm still waiting to hear from them as they are very hard to get in to see. 

I saw my ent who examined me and told me that he would leave things alone and just keep the area clean. I'm cleaning my mouth all of the time. It's not infected and the ent said he thinks the gum pocket has most likely been there since the extraction two years ago. I couldn't see it because its very far back. Ent doesn't want me to do anything that could trigger ORN and fears anything I do could make matters worse. He also said it's unlikely a bone graft will work. So I have 2 issues, not enough bone and an open gum pocket. 

I'm just finishing up 60 hyperbaric dives for radiation damage which has helped some.

I'm confused and don't really know what to do. The last thing I want is to trigger ORN. Does anyone have any suggestions? Thank you.

 

CivilMatt

ORN

Bunnymom,

I bumped an old post up about ORN for you to look at.

Matt

Bunnymom

CivilMatt said:

ORN

Bunnymom,

I bumped an old post up about ORN for you to look at.

Matt

Hi Matt

Hi Matt

 

thank you. I did have a CT in the dentists office. the oral surgeon who looked at it did not feel that I had ORN. They are just concerned that any work could possibly trigger it. I'm just not sure how to proceed. 

MrsBD

Teeth

Did anyone tell you to swish with hydrogen peroxide?  Years ago, I was a dental assistant. We'd have people come in with problems due to a flap of skin over a wisdom tooth. The dentist would flush it out with peroxide and instruct the patient to rinse with it a couple of times a day.  If I notice a sore spot now, I do the same thing and it feels better the next day. My dad had a leg ulcer that wouldn't heal until a new doctor told him to use peroxide. The hole in his leg finally filled in after six months of going to the wound care clinic. Sometimes the simplest ideas work best. I hope your problems resolve soon.

Bunnymom

Hi Mrs

how are you? I finally moved!

I am going to give the hydrogen peroxide a try. Good idea.

MrsBD

Bunnymom said:

Hi Mrs

how are you? I finally moved!

I am going to give the hydrogen peroxide a try. Good idea.

Needed a Break

You moved! It would be great to meet up sometime. I'm doing really well. Just needed a little break from cancer talk, but I'll be checking in again to see if I can be of help to any of the new members.

donfoo

sorry to hear

Hi, 

It sounds like you are in the best of care now so hope it all goes smoothly and you avoid any further jaw bone issues. From your time here you know about ORN so it's especially to push for as much input from the experts on options. Good luck, don

Mikemetz

Triggering ORN

I've never heard that ORN can be triggered.  My understanding is that it comes from too many damaged blood vessels following rads that don't regenerate, eventually cutting off the blood supply to bone tissue, which then dies.  I just thought it happened, or not--and it can take years for it to start in some cases. Either way, take my advice to learn all of the signs of ORN and tell your ENT if and when they pop up.

Mike

 

donfoo

Mikemetz said:

Triggering ORN

I've never heard that ORN can be triggered.  My understanding is that it comes from too many damaged blood vessels following rads that don't regenerate, eventually cutting off the blood supply to bone tissue, which then dies.  I just thought it happened, or not--and it can take years for it to start in some cases. Either way, take my advice to learn all of the signs of ORN and tell your ENT if and when they pop up.

Mike

 

other "triggered" ORN thread

Mike,

There is another post where it appears a crown procedure did some damage to the jawbone and somehow is related to ORN.

Fireman

Osteoradionecrosis

Hello All,

Unfortunately I am one of those people who got ORN. It can be a debillitating disease at times. It happened when a dentist removed a molar from the radiated side of my jaw 7 years after radiation treatment. I saw an oral surgeon after the dentist felt that he was in over his head and recieved the diagnosis from the oral surgeon. I went through HBO treatments which was a rather expensive ordeal with minimal effects for me. I have suffered with this condition for over a year. None of the medication prescribed stops the pain, the intense spasms, the numbness from the nerve involvement, or the continuos facial contortions I have to make to be comfortable. Speaking at times is a challenge because it triggers spasms in my jaw which are quite painful. I have been on a soft food diet for the past year because of my inability to chew solid food without pain and causing spasms. I have a high pain thresh-hold and don't like taking meds, but sometimes I have no choice. The oral surgeon says other than keeping the mouth clean with rinsing with salt water or chlorohexidine mouth wash there is not much more that can be done without making matters worse. He said as a doctor and a surgeon, he so much wants to do something to help me, but knows that anything he does will make matter worse. As far as rinsing goes, that is not adequate if you have a pocket in your gums. That area must be flushed out as I was amazed at how much food can stay stuck in that pocket until I went to a specialist who showed me. Of course that left behind food that I thought I rinsed out caused an infection. My cancer and the treatments for it was over in a matter of months. This ORN process is taking much longer to heal and is much more painful than anything I went through during my cancer treatments. My primary care doctor offered to put me on disability, but I don't roll like that. Good thing I have an understanding employer and great staff to work with. The worst part for me is trying to sleep and feeling like out of nowhere someone came and punched me in the jaw. You never know when the spasms or pain will come. I limited my driving because I was afraid to have a painful spasmodic episode where my jaw locks and sends pain straight to my head to where all I could do is sit and cry. It's been 1 year and one month since my diagnosis and though the pain is less intense and the spasms are less intense, there are times that it still has me finding a place to sit and cry because they are so intense. The tissue in the socket is starting to fill in but my body is still rejecting and spitting out dead bone. There is no telling how long this will last according to all my physicians. Hopefully soon. I still can't chew solid foods and still am awakened at night with those sucker punches to the jaw, though not as intense. I found out the hard way that many dentist have no clue as to what it means when you tell them you had previous cancer and radiation. I also discovered that the whole treatment plan for me was doomed to fail  but, I found out after the fact. The plan was to remove the tooth, place bone graft and then put in an implant. The tooth was removed, the bone graft put in and did not take as my body could not abosrb or heal in that area and my hell began. Had the implant been attempted, the fear is that my jaw would have fractured. I'm a fighter though and hope to see the day I don't have to blend and puree my food any more, that the pain goes away and that I can sleep and talk again without getting interrupted by spasms and pain. Please take note that if you plan any dental work after radiation, consult with an oral surgeon and not just a general dentist or periodontist. Oral surgeons should have the background to deal with ORN where unfortunately in my case, a general dentist did not. I only hope this can help someone else.