Dentist after radiation?

lindab4
lindab4 Member Posts: 8
edited November 2022 in Head and Neck Cancer #1

I had 6 1/2 weeks of radiation. surgery, and chemotherapy in 2011.  I have had teeth extracted in 2016 and had 30 Hyperbaric Oxygen treatments for the

extractions; to help bone heal.  It is now April 2018 and I have more dental issues.  I also have reduced saliva production.

I now live in Killeen, Texas and wonder are there any dentists who specialize in patients who have had oral cancer (base of tongue and lymph nodes)?

I hear many conflicting things.  Can anyone give me advise?  I wish I could have dentures.  

Comments

  • lorig01
    lorig01 Member Posts: 83
    Dentist

    Hi. I live in Houston and go to a wonderful dentist that helped me through my cancer. She specializes in treating oral cancer patients. Her name is Dr. Joanne Marruffo.  She helped me through my journey.  If you can get to Houston she may be able to help. 

     

  • Billie67
    Billie67 Member Posts: 898
    dentist

    Hello, I'm sorry you are having so many dental problems. I worked as an RDA for about 16 years and would love to make a couple of suggestions. I highly advise you to seek out a school of dentistry. They deal with this type of thing a lot! Where did you go for your pre-radiation dental check up? Many radiation oncologists will refer patients to a university school of dentistry. Where do you live and I will see if I can find somewhere for you to go.

    As for the dry mouth, we can all relate to that lovely condition! Have you tried xylamelts? I tried all of the rinses, gels, toothpastes and honestly only the xylamelts create a constant "wetness" to my mouth while I have it in my mouth. I also chew a ton of gum but with your dental issues gum may not work for you right now. The xylamelts stick on the inside of your cheek and slowly disolve all the while creating you to salivate a bit. It will help to keep your mouth to be a little more moist. 

    Let me know if I can help

  • michdjp
    michdjp Member Posts: 220
    Billie67 said:

    dentist

    Hello, I'm sorry you are having so many dental problems. I worked as an RDA for about 16 years and would love to make a couple of suggestions. I highly advise you to seek out a school of dentistry. They deal with this type of thing a lot! Where did you go for your pre-radiation dental check up? Many radiation oncologists will refer patients to a university school of dentistry. Where do you live and I will see if I can find somewhere for you to go.

    As for the dry mouth, we can all relate to that lovely condition! Have you tried xylamelts? I tried all of the rinses, gels, toothpastes and honestly only the xylamelts create a constant "wetness" to my mouth while I have it in my mouth. I also chew a ton of gum but with your dental issues gum may not work for you right now. The xylamelts stick on the inside of your cheek and slowly disolve all the while creating you to salivate a bit. It will help to keep your mouth to be a little more moist. 

    Let me know if I can help

    Hi Billie,
    Hi Billie,

    I live in Staten Island, New York and wonder if you know any dental schools near me. My dad is suffering from dental issues from treatment. He has lost many of his bottom teeth and has had all of the side ones grinded down from root canals.
    Thank you so much.
    Michelle
  • Billie67
    Billie67 Member Posts: 898
    michdjp said:

    Hi Billie,
    Hi Billie,

    I live in Staten Island, New York and wonder if you know any dental schools near me. My dad is suffering from dental issues from treatment. He has lost many of his bottom teeth and has had all of the side ones grinded down from root canals.
    Thank you so much.
    Michelle

    OK so asking around in the

    OK so asking around in the dental world, I've had 3 reccomendations to Dr. Abbott 972-226-6947 at Dental Oncology Professionals. I'm not exactly sure where in New York they are but 3 recommendations by 3 different doctors is pretty valuable. 2 of them also told me that NYU Dental school is good! I know they are in NY NY. 

    Your dad sounds like he has a big case but not an impossible case. 

    Let me know if I can help in any other way

    Good luck, sending positive vibes!

  • michdjp
    michdjp Member Posts: 220
    Billie67 said:

    OK so asking around in the

    OK so asking around in the dental world, I've had 3 reccomendations to Dr. Abbott 972-226-6947 at Dental Oncology Professionals. I'm not exactly sure where in New York they are but 3 recommendations by 3 different doctors is pretty valuable. 2 of them also told me that NYU Dental school is good! I know they are in NY NY. 

    Your dad sounds like he has a big case but not an impossible case. 

    Let me know if I can help in any other way

    Good luck, sending positive vibes!

    Thank you very much for the
    Thank you very much for the recommendation. I will let you know how it goes.
    I have asked around and gone to a few dental seminars in my area but no
    Dentist really had any positive input which in this day and age is so disappointing
    Your recommendation comes with hope and sometimes that's all you need.
    Many thanks
    Michelle
  • michdjp
    michdjp Member Posts: 220
    Billie67 said:

    OK so asking around in the

    OK so asking around in the dental world, I've had 3 reccomendations to Dr. Abbott 972-226-6947 at Dental Oncology Professionals. I'm not exactly sure where in New York they are but 3 recommendations by 3 different doctors is pretty valuable. 2 of them also told me that NYU Dental school is good! I know they are in NY NY. 

    Your dad sounds like he has a big case but not an impossible case. 

    Let me know if I can help in any other way

    Good luck, sending positive vibes!

    Dentist
    Hi Billie,
    So thank you very much for the information I called dr. Abbott (he is in Texas) and he recommended dr. Lee in NY my dad and I are going today for consultation.
    Again many thanks and I will keep you posted
    Positive vibes!
    Michelle
  • NicholasAnderson
    NicholasAnderson Member Posts: 1
    edited March 2021 #8
    I had problems with my teeth

    I had problems with my teeth in 2012 due to long chemotherapy, they began to break very much and lost their strength and lost their color.

  • motorcycleguy
    motorcycleguy Member Posts: 478 Member
    edited March 2021 #9
    linda,

    I'm not sure if this is directly related to your inquiry or not, but I'll share anyway.

    I just got off of a construction site, that I had been on for over a year.

    It was in a small town in Oregon.

    I finally came home for a period of time, and I lined up a teeth cleaning. My tooth cleaner asked me to come in early, as it had been a year, since last cleaning.

    When he looked at my mouth, he said my teeth looked like they had just been cleaned, had virtually no plaque on them, and my gums looked healthier than ever.

    I realized in the year I was travelling, that the water in the town was often a brownish color. So, I started drinking bottled water. My girlfriend told me that 9pH (Alkaline) water was good for preventing the return of Cancer - so I drank a couple gallons of that a week.

    Well, I'm not sure about 9pH Alkaline water for preventing Cancer return - but it sure seemed to work wonders on my teeth and gums!!

    MG

  • tommyodavey
    tommyodavey Member Posts: 726 Member

    linda,

    I'm not sure if this is directly related to your inquiry or not, but I'll share anyway.

    I just got off of a construction site, that I had been on for over a year.

    It was in a small town in Oregon.

    I finally came home for a period of time, and I lined up a teeth cleaning. My tooth cleaner asked me to come in early, as it had been a year, since last cleaning.

    When he looked at my mouth, he said my teeth looked like they had just been cleaned, had virtually no plaque on them, and my gums looked healthier than ever.

    I realized in the year I was travelling, that the water in the town was often a brownish color. So, I started drinking bottled water. My girlfriend told me that 9pH (Alkaline) water was good for preventing the return of Cancer - so I drank a couple gallons of that a week.

    Well, I'm not sure about 9pH Alkaline water for preventing Cancer return - but it sure seemed to work wonders on my teeth and gums!!

    MG

    Water

    Motorcycle guy.  What a great suggestion about the water.  I wonder how much truth is in it.  A local water company specializing in alkaline and other additives was just pulled from the shelf as it was causing hepatitis.  Just don't drink Real Water.  It's probably off the shelves by now anyway.  I'm going to try the alkaline water and see if it helps.  Thanks again.  (btw, I too am a motorcycle rider)

  • TisiKisit
    TisiKisit Member Posts: 1
    Cosmetic dentistry is a type

    Cosmetic dentistry is a type of dentistry in which the patient's natural teeth are injured or missing due to an accident or disease. To get cosmetic dentistry, a patient generally undergoes a period of rehabilitation in which they endure pain medication for several days before undergoing a treatment to rebuild their natural teeth. During this period, the dentist can make minor adjustments to the rest of the patient's teeth. I had no issues with my natural teeth, so I contacted cosmetic dentistry in Eastlake, Ohio. The doctor from there did a great job.

  • wbcgaruss
    wbcgaruss Member Posts: 2,260 Member
    edited August 2021 #12
    TisiKisit said:

    Cosmetic dentistry is a type

    Cosmetic dentistry is a type of dentistry in which the patient's natural teeth are injured or missing due to an accident or disease. To get cosmetic dentistry, a patient generally undergoes a period of rehabilitation in which they endure pain medication for several days before undergoing a treatment to rebuild their natural teeth. During this period, the dentist can make minor adjustments to the rest of the patient's teeth. I had no issues with my natural teeth, so I contacted cosmetic dentistry in Eastlake, Ohio. The doctor from there did a great job.

    Well Tisi

    I am glad you got excellent results and are so happy with the dental establishment that you posted their office.
    Welcome to the forum it is always good to have a new member with another set of ideas but sorry you are here for the reasons we all are in this group.
    I too have been surrounded by excellent dental and medical doctors, nurses, staff, and many others.
    If you can could you also give us a brief summary of your cancer situation and the treatment you went through?
    It would be nice if you could post a picture of your wonderful smile post-treatment.
    Here are picture posting instructions from one of our forum members  https://csn.cancer.org/node/255838

    congratulations and Wishing You The Best-Take Care-God Bless-Russ

     

  • nhdal
    nhdal Member Posts: 2 Member

    This morning is my first on this site. I am 85 years old and was diagnosed with a cancer on the base of my tongue January 2020. I had proton radiation treatments from 3/4/20 till 4/30/20. I was cleared by my dentist before radiation. Thankfully the cancer is gone but the side effects linger on. No taste, smell or saliva. On this site I read about Xylimelts. I immediately purchased them. They work wonders. Much better than lozenges and dry mouth washes. I am also having dental problems. I have three teeth that need extraction. No oral surgeon will touch me without hyperbaric treatments. Medicare refused to cover it. Now what? My dentist is working with me for help. So far no luck. Eating is a real problems. I cannot chew properly and another piece of tooth has broken off. My dentist referred me to VCU School of Dental Medicine in Richmond, VA. They will not return my calls. I have no taste or smell. My ENT doc just prescribed Pilocarpine (Salagen) 5M to help with the dry mouth. After three weeks I see no difference but will continue to take it. I would like some kind of denture but am told I am not a candidate for them because of my dry mouth. Is there any help for me? My quality of life has deteriorated. I eat only soft food because of my inability to chew properly. Other than that I feel good and stay active. Dave L

  • wbcgaruss
    wbcgaruss Member Posts: 2,260 Member


    Hello, Dave, welcome to the CSN H&N discussion board, glad to have you.

    I would imagine at your age even at the date of treatment a couple of years ago it was pretty rough on you.

    My congratulations on getting through it and conquering cancer.

    I believe you are one of the oldest members here, others feel free to chime in.

    I too use Xylimelts and I agree they work about the best that I have found.

    I use them overnight mostly and chew Trident gum in my waking hours for dry mouth, it stimulates saliva production.

    My dental hygienist has me using Act Dry Mouth Mouthwash which helps dry mouth for a short period but mostly helps with tooth preservation.

    I am sorry you ended up with no taste or smell you got a double whammy there, there are some on here that have one or the other or some problem other than that but unfortunately, you got 2 things that are challenging.

    I understand why they want you to get the HBOT it is important, I had 30 treatments a couple of years ago with 10 follow-ups.

    Do you have a medicare supplement like Aetna, Humana, or another that usually covers it?

    I would recommend if you can afford it one way or another get it done.

    It does not guarantee you not having a problem but certainly gives you the advantage to avoid getting osteoradionecrosis (ORN)


    https://oralcancerfoundation.org/complications/osteoradionecrosis/


    I would recommend getting back with your cancer care team and seeing if they can give you any assistance.

    I have an oral surgeon that works closely with providers and consulted with my radiation docs on my radiation area and strength of radiation.

    If you can get set up with an oral surgeon they may be able to work with your radiation team and put in a recommendation to medicare telling them it is necessary for your situation.

    Another option might be to get with an HBOT provider in your area and see if they would negotiate with you for a lower fee for the services they provide and make it affordable for you.

    Just some ideas.



    I did find this information on Medicare coverage--


    Does Medicare cover hyperbaric oxygen therapy?

    If you are enrolled in Original Medicare coverage (Part A and Part B), hyperbaric oxygen therapy may be covered under Medicare Part B if used to treat certain approved conditions.

    Conditions, when you may be covered to receive hyperbaric oxygen therapy under Medicare Part B, may include(but are not limited to):

    • Acute carbon monoxide intoxication
    • Decompression illness
    • Gas embolism
    • Gas gangrene
    • Acute traumatic peripheral ischemia
    • Crush injuries and suturing of severed limbs
    • Progressive necrotizing infections
    • Cyanide poisoning
    • Diabetic wounds of the lower extremities if you meet certain criteria

    The treatment must be medically necessary and administered in a special hyperbaric oxygen therapy tube or chamber. In some states (Illinois, Michigan, and New Jersey), you may be required to get prior authorization before receiving the treatment unless it’s an emergency. Part B will pay 80% of all allowable charges; you are responsible for the remaining 20% plus any applicable Part B deductible.


    I have never heard that dry mouth condition would not let you have a denture but a little research has enlightened me, I found this site for example--

    https://www.rabelfamilydentistry.com/why-dry-mouth-can-be-a-problem-for-denture-wearers


    I hope you find some answers, quality of life is a big deal.

    I am impressed that you feel good though, stay active, and have a very positive attitude.




    Wishing You the Best

    Take Care God Bless-Russ

  • nhdal
    nhdal Member Posts: 2 Member

    Thank you Russ for your feed back. I purchased the Xylimelts you recommended. They work much better than the lozenges I have been using. I do use Act Dry Mouth Wash and drinks lots of water. Thru my dentist I have an appointment February 28 at the University of Virginia Dental School. Because of the radiation I have had several pieces of teeth break off. Also because of dry mouth my dentists said decay would happen much quicker. I am very careful to keep my teeth clean. Have a Water Pik brush and floss-er and use it after eating. I am retired military and have Tricare for Life plus Medicare. When medicare denied my claim for HBC I was told they do not cover preventive medicine. If I had an some sort of infection they would cover it. I contacted my Congressional representative and after 6 weeks was sent copies of medicare and HBC coverage from him. What a waste. Also how to get help challenging a claim. I am now waiting until my visit in February to pursue that.

    Thanks also for the link about dentures after radiation. I have read that and at some point hope that might be possible. New things are happening daily.

    I was warned before radiation about tooth problems. Unfortunately not in detail. I was also cleared by my dentist.

    Thanks again for the help.

    Dave

  • wbcgaruss
    wbcgaruss Member Posts: 2,260 Member

    You are very welcome Dave, I hope some of it was a help.

    I also No.1 want to thank you for your service to our country.

    Dental problems are a big deal with head & neck folks. Between the radiation and lack of saliva which hurries on more tooth problems, this is a tough situation for many H&N folks. Here is some more info on saliva which we used to take for granted.

    Saliva isn’t something you probably spend much time thinking about. But did you know that every moment of every day it affects your health? Saliva is vital for a healthy mouth, good digestion, and more. Read on to learn how saliva does a body good!

    What is saliva?

    Saliva is 98 percent water. It contains small amounts of important substances, including mucus, proteins, minerals, electrolytes, antibacterial compounds and enzymes. Saliva moistens the mouth for comfort, lubricates as you chew and swallow, and neutralizes harmful acids. It also kills germs and prevents bad breath, defends against tooth decay and gum disease, protects enamel, and speeds up wound healing.

    Saliva originates in the three pairs of major salivary glands and in hundreds of minor glands surrounding the oral cavity. The major salivary glands responsible for most saliva production include the parotid (inside cheeks), sublingual (under tongue), and submandibular (near jawbone).

    Tiny tubes called salivary ducts carry saliva from the glands into your mouth. Small amounts of saliva enter the mouth constantly to keep the mouth moist. The salivary glands really kick into action when you eat, or even just think about or smell food. Then your glands make lots of saliva, and you can notice much more of it in your mouth. An average person produces 2-4 pints of saliva every day.

    Why is saliva important?

    Saliva is an important part of a healthy body. Research shows that it protects against gum disease, tooth decay, and other oral infections. A thin film of saliva covers teeth and buffers against bacteria, while antimicrobial agents in saliva kill disease-causing bacteria. As saliva moves around the mouth, it sweeps away small bits of food that feed the bacteria responsible for tooth decay.

    Saliva neutralizes acids in the mouth that break down tooth enamel by washing away acidic residue from eating. When acid damages enamel, saliva repairs the tooth’s protective surface in a process called remineralization. Calcium, phosphorous, fluoride and other minerals contained in saliva repair the enamel surfaces of teeth, keeping them healthy, strong and resistant to cavities.

    Saliva also plays an important role in digestion, thanks to an enzyme called amylase. Digestion begins in the mouth, when amylase breaks down starch, maltose and dextrose into smaller molecules. It also helps you to swallow food, by making it wet and soft, so it can slide down your throat more easily.

    I am glad you are taking good care of your teeth, I am too the best I can. Like you, I can see my teeth getting affected from rads and lack of saliva.

    I did read that on the medicare coverage site that they cover HBOT to fight an infection but will not approve it to prevent a problem. How dumb is that? Go ahead and get a tooth pulled and if it won't heal and your jaw gets infected we will cover it then.

    Best of luck to you Dave.

    Wishing you many Blessings and a great Thanksgiving.

    Take Care God Bless-Russ