Dental restoration post tx

Foo,

I just went to my dentist last week for a cleaning and examination, 4 months post Tx. I don't really know his experience with OC patients but he seems to know what he's doing. He examined me and certified me radiation ready prior to treatment and was in communication with my team. He examined my mouth, felt around my neck etc. and did the cleaning. 

As of now, other than sensitivity in my teeth and gums to extreme hot and cold, I have no dental issues to be converned with. However, based on some of the horror stories I've read, I would seek an experienced dental professional experienced with H&N patients should I need serious work. There is one at Johns Hopkins. For now however, I'm confident in my dentists abilities.

"T"

I have wondered the same thing. I am only 28 & my teeth were in good shape before treatment so no need to pull any. I was scheduled to have an implant prior to treatment because of an adult tooth that never came in. I also have a crown on a front tooth because of an accident when I was younger. My dentist wants to replace the crown & do a crown lengthening because the crown was originally placed too close to bone & therefore causes inflammation in my gum. I had a cleaning last week & my dentist said that the biggest concern is non healing of bone. He said it happens in 1-2 percent of cases & usually on the bottom jaw. However, they won't do any work until my ENT signs off & my ENT said he doesn't know enough about it to give consent. So...I guess I'll talk to my RO next time I go. I have looked for  a dentist that is experienced in treating pts with radiation but have had no luck. Don, if you find out any more info, pass it my way!

two small cavities filled, a broken tooth pulled and a root canal/crown.  Yay me.  The dentist has to call my rads onc because he doesn't think that is all needed right now...It's too soon he says. 

lorig01 said:

Teeth

Hi.  My dentist did her internship at MD Anderson and understands the effects of radiation on teeth.  For me, she recommended all teeth out. My oral surgeon agreed. I have implanted dentures now and had the implants put in prior to radiation. The could only do 7 posts because of the field of radiaion.  It took a while to get used to but i am able to eat almost anythign and they look great.  I was really worried about dental work done after radiation and I have always been plagued with dental problems.  I used to have my teeth cleaned 4 times a year and I still had occasional crowns or fillings needed.  I think it is hereditary.  Anyway, I figured I might as well get all my dental costs done upfront   I have had really good luck witht he implanted dentures.  I would recommend them to anyone who is having treatment for head and neck cancer.  I have heard of some folks getting the implants after radiation.  Not sure about that. I am 1 year out from treatment of stage III tonsil cancer.

I am in the Houston area. If anyone needs a dentist familiar with the effects of radiation treatment on teeth I can highly recommend Dr. Joan Marruffo at Medical Center Dental.  In addtion to creating outstanding dentures for me, she walked me through what to expect from radiation treatment and was a compassionate cheerleader throughout my cancer treatment. I think I learned more from her on what to expect than from all of my other doctors. I cannot speak highly enough of her. She was a "life saver".

donfoo said:

that was radical

Hi,

Your case seems quite unusal, to have all your teeth pulled and implants done before radiation. It seems most of us are overloaded just dealing with the direct cancer issues much less having the time and energy to go through with such extensive dental work. As is said here many times, each of our journies on the cancer road are unique so there must have been some circumstances that necessitated so much work and causing delay in radiation treatment due to dental recovery. don

I have known a few on here that also were told to have all of their teeth pulled prior to Tx... Definitely not the norm, but unfortunately not rare... I'm sure each had other things going on that led to that decision by their MD's..., or at least I hope so.

JG

donfoo said:

New criteria for certain

With cancer, going to the dentist takes a different path. I have read about hyperbaric oxygen treatments and also significant issues when considering implants. Also, as Denis remarks many of us are going to have more serious dental issues and more complicated fixes due to our cancer history.

Cancer barely slowed down my eating but the missing teeth cause most issues of all as it becomes harder to chew and find places where I don't jam food into my gum. That is the reason for getting some dental fix in place. 

But options may be more limited, especially this early into recovery and added costs to get those fixes in place. Then there is the consideration of spending big bucks only to have it all fall apart if the jawbone starts failing and other teeth start cracking off. Just another new twist cancer throws in the road ahead. Still glad to have that to worry about and not far less appealing alternatives.

Dentures comes up as an option, maybe partial dentures for those not losing teeth wholesale. Has anyone ventured to get implants post tx or other solutions to patch missing or failing teeth?

I'm assumming as long as the root is strong and solid, procedures such as root canals and crowns would likely not create any unusual concerns.

My husband is currently in the process of starting implants.  He had jaw cancer and had his right jaw removed on the right side in Feb. 2012.  He had radiation prior to his surgery, and all the implants are being done in bone and tissue that was never radiated, as this tissue and bone is from his leg and fibula.  His oral surgeon and head and neck surgeon are optimistic that he won't have any problems.  They also said that they wouldn't have recommended the implants if the bone and tissue implanted had ever been radiated.

As far as regular dental care, he gets 4 cleanings per year at our dentist's office.  We are lucky that our insurance pays for three cleanings per year.  We are beginning the fight to get insurance to pay for implants and keeping our fingers crossed.

did anyone have dental advice as to what to do during rads?  before rads?

ron had to get flouride trays made and do daily flouride treatments to help protect the teeth.

they also got him a hydeo flosser, (kind of like a power water pic, pressure washer for the mouth)

just wondering if anyone did the flouride treatments daily , and have they had any problems.

janet

jim and i said:

hyperbaric treatment

Does everyone have to have hyperbaric treatment before dental treatment? Does insurance cover this? Jim's teeth are crumbling but we do not have funds to go to dentist let alone hyperbaric. Does medicare cover these teeth problems because they are result of tx? I have many questions.

Debbie

deb, unfortunately from posts on here i think u will have 2 fight w/medicare to pay for that.  several people here have been thru it already.  i'm sure they'll give you more info.  good luck.

dj

Skiffin16 said:

Flouride

Janet, I think most on here were advised, or underwent some discussions concerning flouride. 

A lot of us did/do or are using flouride daily... I did for about a year, then tapered off to about once or twice a week as my saliva improved. Now maybe once a week or so... I have about 95% of my saliva back. Saliva (or lack of) I believe being one of the more important factor as for tooth decay.

But as for radiation damage, I'm pretty sure that flouride doesn't do much.

Just my thoughts anyways...

John

Not one word about flouride was ever mentioned to me.  I ended up with 2 or 3 cavities after rads that were not there before