Teeth

Logan51

Recent post got post-Rad damage to teeth and dealing with opened, so thought I'd contribute.

1) Was told 1-1/2 years after last Rad by the U. of Iowa that flouride tx., daily, should be started before tx, thru tx and continue to end of life. Came as a shock to my Rad Dr., who didn't have a clue. Head Dentist @ U. of Iowa told me that's been a standard, there, for almost 30 years. There is a toothpaste that's prescription level, and the flouride trays.

2) The loss of gum tissue does happen, but is deceptive. The Rads cause swelling, and in time that swelling recedes to reveal the actual damage- or so I was told. The bottoms of a tooth on each side of my lowers showed in the months after my tx, and a Periodontist had to literally grind away the exposed root areas of those two teeth exposed to the degree that gum tissue eventually grew and covered those two spots. I noticed due to sores on both sides of tongue, then saw the whites on inner gums in wisdom tooth area.

3) The Rad hit to saliva glands directly impact teeth- saliva cleans teeth and is critical to healthy mouth.

4) Rads do destroy the protective enamel on teeth, to varying degrees. Lot depends on amount of Rads the teeth get hit with. Between loss of saliva and Rad damage- loss of tooth Matter does happen.

5) The tops on teeth can be rebuilt. From my Dentist- $200/tooth. So far, 12 teeth for me, have several done twice, and need done again to several. Typical is front teeth: can actually see the inner teeth on front lowers, with a thin line of blood between the inner and outer part of teeth. Other teeth it's typical on not only the tips of teeth, but also the inner-tops of teeth. Not sure what they use, but does cover the tops with a layer of unknown white stuff that require a couple heat zappings to bond to teeth. If your Dentist does not know about this- make them aware, or get a referral to another Dentist who does. This technology has been around for at least 8 years.

6) I've had 2 Root Canals and 3 new Crowns since Rads over last 10 years. Not uncommon. Was told the Rads can actually do damage to Crowns, which is why one Crown needed to be replaced- the metal top of Crown was vanishing.

7) The Rad damage to the tiny blood vessels in jaw and teeth are issues which can lead to tooth decay, and the Osteoradionecrosis which leads to partial, or more, jaw replacement.

8) Post-Op., there is an amount of time to pass before a tooth can be pulled without a negative impact. I was in chair with a Dentist specializing in Tooth yanking when he called Rad Dr., about 8-months post-Rads, and just like that it gets cancelled. Alternative was a RC and Crown. Rad Dr. scolded my Dentist for not finding problem area before tx.

9) If you do need a RC, I would advise having it done by a Periodontist. Comparing said to my regular Dentist- major difference in favor of the Periodontist to the degree of shock, to me: no pain, or even discomfort.

10) Dental X-rays every year are of value- so the Dentist can compare to previous years and find deterioration. This showed on one of my teeth at the gum level, and led to my Periodontist RC.

 

These are just 10, and there are no doubt more. Just thought I'd FYI contribute. What confounds me- why can't they invent a tooth protector to cover teeth in Rad sessions? The teeth don't have the C, so why should they suffer? Makes no sense.

 

ERomanO

Your last 2 questions...

...make sense to me, but maybe there is some medical logic behind it.  What would be a suitable protective material?  Lead?  That's the only material I can think of, and I'm not sure it would protect against gamma rays.  Plus, I'm not sure I'd want a couple sheets of lead in my mouth 35 times for 10-15 minutes each time.

I'll ask my rad onc when I go back for my 9 month checkup on April 4

tommyodavey

Team Dentist

Have you asked your primary C doctor for a recommendation to an Oral Surgeon familiar with oral cancer patients?  Mine is part of a team and he gives me a discount on the flouride paste and trays.  Doesn't hurt to ask.

No answer on the rad protection for teeth.  A great question though.  If a person can invent one they'd be rich.

Sorry about the dental problems.  We all face it who had rads.  Some later, some earlier.  I also searched for a regular dentist who was comfortable treating rad damaged teeth.  Working on the gum line is difficult and some don't want to do it.

dalaitom

My radiation oncologist

My radiation oncologist insisted that I wear my lower flouride tray for each treatment. He said it helps break up the rays to make them less damaging to the teeth/jaw.

 

Logan51

@dalaitom

That is interesting. Years ago there was a post where a tooth protector was mentioned as having been used. Seems like it might have been Sloan-Kettering, Farber, or one of the east coast major C centers. But that was the one and only post I remember ever seeing it mentioned- and I'm pretty sure what was used was not revealed.

dalaitom

Logan51 said:

@dalaitom

That is interesting. Years ago there was a post where a tooth protector was mentioned as having been used. Seems like it might have been Sloan-Kettering, Farber, or one of the east coast major C centers. But that was the one and only post I remember ever seeing it mentioned- and I'm pretty sure what was used was not revealed.

It was so important to my RO

It was so important to my RO that they wrote on my radiation mask "lower tray only" and they checked every time to make sure I was using the lower tray. They even told me the doctor wouldn't allow me to have my radiation treatment if I wasn't wearing the tray.

 

wbcgaruss

Trays for the Teeth

Were never mentioned to me at any time I only knew they existed because of reading about them on this forum. You would think all the cancer treatment facilities and hospitals would have something like this and many treatments standardized between them all. But I guess not they all have a little different idea about treatment protocol's.