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.
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