Tooth Extractions

Skiffin16 said:

Welcome
Welcome to your new world of Dentistry after radiation....

What you were told is pretty much standard, doesn't mean that it is a definite though.

The oral dentist is standard in asking for how many grays, etc....

Hyberbaric chamber is also not uncommon....

It all relates to the radiation and how your body handled it. If you still have good blood flow in the lower jaw...all things they shouyld have went over with you before rads...

I believe the SuperThread has refernece to this subject as well.

SuperThread

Look down to the section: "DENTAL ISSUES AFTER RADIATION FOR HNC::


But there are some on here that have had extractions without having to go through the chamber....

I'm not sure how they determine, if it's X-Rays or what that allows them to see the tissue, blood flow, etc...

Someone with actual expereince will add to this thread.

Best,
John

Just went through much of the same
Hi Arthur

I went through exactly the same decision process for a tooth extraction early this year. I will relate some of the wisdom I discovered along the way. The recommendation of 20-10 is standard for tooth extraction post radiation. Hyperbaric treatment is an established protocol and well regarded as having value. Many here have gone through it. I was able to avoid it based on my personal circumstances and my relationship with my dentist. It is mainly an issue of healing after extraction. Severe complications can result and really complicate recovery. There are instances where people don't heal or damage to the jaw bone occurs/cracks/fractures. These are the variables for your dentist to consider:

location of teeth to be extracted
location of the oral cancer
upper or lower jaw bone
degree of radiation on that side
difficulty in the extraction, i.e. degree of tissue damage expected in the extraction
skill of the dentist/surgeon

My extraction was on the lower left. My lower left received 50 greys of radiation. My cancer was base of the tongue to the right of the mid line thus my heavy radiation was on the right side at 70 grey. The top jaw bone is thicker than the bottom. The denser the bone the more radiation is absorbed. The more absorption the more brittle the bone becomes. As you can see the the variables favored the extraction or at least made it plausible without hyperbaric. Additionally my dentist tried a leverage assisted extraction with a rubber band and spring which ultimately failed but I think gave him some wiggle room.

There are limited facilities that do Hyperbaric treatment. Hyperbaric has many applications especially wound care and children with learning disabilities. There are chambers that house multiple patients and mono chambers at some local hospitals. It is possible to do two treatments in one day with several hours of waiting in between. Insurance will most likely pay for head and neck patients as it is an established protocol. Hyperbaric will be needed for each additional procedure. Contrary to some postings it does not last forever. Retrospectively it would have been easier to just get the hyperbaric done than all the visits for the experimental spring/band extraction. Hope you find the right remedy for your circumstances.

Broken jaw

my husband went to oral surgeon because he needed to have a molar removed.  Long story short, one week post extraction, his jaw broke simply opening his mouth wide for an X-ray.  Surgeon says expect at least 10 weeks healing, didn’t ever mention hyperbaric.  Should we look into it?  Hubby is in a lot of pain & very discouraged.

 

wbcgaruss said:

Check With

Your oral surgeon for his opinion but HBOT will help your body heal faster. Every little bit helps for us cancer folks.

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

thank you so much for your

thank you so much for your opinion.  i am a bit disappointed that the oral surgeon didn't recommend it at all, that he's not said anything about what exactly to eat on a liquid diet, just "hope it heals."

 

Logan51 said:

If I were you

I would ask the Oral Surgeon exactly what he/she knows about Osteoradionecrosis. The integrity of the jaw has been compromised by the lack of blood flow if that is in play. Find your post interesting because my Dentist had me go thru a root canal and get a new Crown on a tooth because of an X-ray showing him something- said it had to do with blood flow and deterioration.

I was about 6-months post-tx when my Dentist said I had to get a tooth pulled. I was in the Oral Surgeon's chair and about to have pulled when she asked me about my C tx. She then called my Rad Dr., who got very angry and cancelled the pulling of the tooth, resulting in my first root canal, post-tx. My Dentist told me the Rad Dr. called him and verbally let him have it, so to speak- said he should have detected the issue in my Dental X-ray before tx started. 

I see you joined the forum in 2011, olybee, so assume his tx was that far back. My ENT Dr. said Osteoradionecrosis becomes an issue with many H&N Patients who get zapped in the jaw some 10-15 years down the road, and does result in loss of blood flow and the resulting impact to that area of the jaw leaving one prone to such as breaks- like your Husband had. And to have a tooth pulled, then a week later this happening...sorry to hear about, of course, but good information for all of us to have.

Hope you will update us on his situation and progress.

Thanks for the info, Dave.

Thanks for the info, Dave.  The saga continues.  We’re waiting on approval for hyperbaric  treatment, he’s been back three times now.  Two days ago they put in a drain, “cleaned up the bone” and are hoping it will now heal.  Very painful & frustrating