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Hyperbaric Medicine

ljoy's picture
Posts: 94
Joined: Dec 2007

Four and a half years after tonsil cancer treatment another phase of the cancer journey has entered my life. While eating a few weeks ago I bit down on a piece of food and felt what I thought was a loose crown.I immediately made a dentist appointment.

A quick exam revealed a loose tooth as opposed to a loose crown. The x-ray showed tissue and bone deterioration around and under the tooth. It is my right lower jaw tooth. It is also the side I received the most radiation (7200 rads). My dentist referred me to an Endodontic specialist for a root canal. Based on the x-ray and oral examination he was not sure the deterioration was caused from a root problem. However, based on my history and wanting to do everything possible to save the tooth he preceded with a root canal. Afterwards he suggested I see a peridondist as well.

I decided to seek a different opinion at this point. I met with the Radiation Oncologist at the cancer center where I volunteer and serve as a mentor for Head and Neck patients. He referred me to an oral surgeon who treats a lot of cancer patients. After further examination he has determined it is radionecrosis (tissue damage from radiation treatment). Even a lay person can see the change in the bone and tissue around the tooth.

I began Hyperbaric Chamber treatmenta last week. I will have thirty treatments and then oral surgery to remove the tooth. Another ten treatments will be necessary after the surgery to help promote healing of the bone and tissue. If they pull the tooth before the hyperbaric treatments they are convinced it will not heal.

The good news is the treatments are painless. However, I have a 75 mile commute one-way to the facility. The treatments are an hour and fifty minutes. The chamber holds 8 - 10 patients per session. I have had a little problem keeping my ears clear from the pressure. It is suppose to get better as I complete more treatments.

Hopefully, the hyperbaric treatments will restore circulation to the damaged area. This will reduce the amount of dead bone to be removed during surgery and help the area to heal properly afterwards.

This has nothing to do with good oral hygiene after treatment. So everybody please continue to be diligent in checking your mouth for any potential problems. I feel my regular dentist could have done a better job. I had a checkup and cleaning in early December and the loose tooth was not detected. Perhaps we all should consider annual x-rays to look for tissue and bone deterioration from radiation.

It is also very interesting that three other patients receiving treatments for the same reason. I will post an update once I finish to let all of you know how successful the treatments were in preventing further problems.

Pam M's picture
Pam M
Posts: 2196
Joined: Nov 2009

Thanks for the info, ljoy. I often wonder about the potential necessity of hyperbaric treatments (and loss of jaw from necrosis) - sometimes I'm sorry I didn't have all my teeth removed prior to treatment. Are you willing to let us know the cost of the treatments? I've heard it's amazing.

Here's hoping that the treatments are successful, and your circulation is restored.

stevenl's picture
Posts: 587
Joined: Jan 2010

Hi All,

I was told by my dentist that I would be miserable after treatments with dentures.
She assured me that she was not talking about cosmetically but pain would be involved.
Glad I opted to have some implants and heavy cleaning done before I started treatment.
I did lose 6 teeth that were in bad shape. Hope the treatment goes well ljoy.


ljoy's picture
Posts: 94
Joined: Dec 2007

I'm told it is around $1200 per treatment. It is actually a medical cost and not dental since it was caused from cancer and the treatment. So I'm lucky to have good medical insurance to cover the cost. I will let you know how much out of pocket I have when the bills roll in.

ratface's picture
Posts: 1319
Joined: Aug 2009

I recently met a woman in group who is on her second jaw bone replacement from titanium, She broke the first one. She has gone through 40 of these chamber treatments and highly regards them. oh, by the way she is on her fourth recurrence and going strong.

delnative's picture
Posts: 450
Joined: Aug 2009

That's good information. I feel blessed that I got my treatment at Johns Hopkins, where they assigned a specialist dentist to my case. I believe I'm doing all the right things in taking care of my teeth, and it just infuriates me to read posts on this and other forums from H&N patients who never were informed of the effects of radiation on the teeth and jaw and what to do to counteract that. As far as I'm concerned, failing to inform a patient borders on malpractice.
I do hope that all works out for you -- but, armed with information and the right treatment, the odds should be on your side.

--Jim in Delaware

staceya's picture
Posts: 720
Joined: Jan 2010

Dear Jim,
I had a cleaning just prior to rads (8 left of 35)
I was told to do weekly floride seals, daily floride toothcleaning.
I am worried that I may be missing info..what do you suggest?

delnative's picture
Posts: 450
Joined: Aug 2009

Hi, Stacey.
Here are the instructions I got from my dentist at Hopkins.
I use fluoride trays with Prevident each night before bed, leaving the trays in place for 10 minutes -- no rinsing afterward, though I sometimes cheat just a little. The doc told me I'll be doing the Prevident routine until the day I die. (After that, I can quit.)
I brush my teeth with Biotene toothpaste. That was the brand the doc recommended, and he warned me never to use any toothpaste advertised as a plaque-fighter. I also floss regularly and have my teeth cleaned and checked three times a year instead of two. In addition, the dentist told me never to let my regular dentist or hygienist use a Cavitron (ultrasonic cleaning) on my teeth, but to do it manually instead.
I also stay away from sugar.
Thus far I've made out OK.

--Jim in Delaware

Hondo's picture
Posts: 6643
Joined: Apr 2009

Very good post thank you so much for sharing it with us; please keep us up to date on any new developments. I know I will need it someday just not looking forward to it just yet.

All the best to you my friend

Posts: 288
Joined: May 2003

I had radiation treatment in the head/neck area twice. Nobody said anything about my teeth until years later my dentist told me they had been damaged by radiation. He has lots of experience with cancer patients. I had my teeth cleaned every 4 months until the only thing left to do was to pull them out. I had to see an oral surgeon who, after talking to my radiologist, recommended 40 sessions in the hyperbaric chamber because there was damage to my jaw bone. He said if he just tried to pull my teeth, the bone might crumble. I had 30 sessions, surgery and implants and then 10 sessions more.

It's been a few years since then and I haven't had any problem. Surgery and implants was for my upper jaw. My dentist has been helping me take care of my lower teeth but last year I had problems with my thyroid which made my mouth dryer than it usually is and, of course, my teeth suffered. I tried a different chamber this time but only went once because I still had problems with the thyroid and the chamber was hard on my eyes. The first time in the chamber was easy, no problem.

The first time my insurance covered the whole cost of the sessions because it is not considered "dental" which I don't have. I have new insurance and I am trying to find a place approved by the insurance.

I definitely want to go somewhere good but also one approved by the insurance. This last place I went to was not so good plus they didn't tell me they had no contract with my insurance. As expected, my insurance did not pay for the one session. It was about $1,700, later it went up to over 2,000. When I requested the details I found they were not only charging for the session for also for the use of the helmet, about 500.00. I told them that since they had kept the helmet, I would not pay for it. In the end, I paid only 1,720 for the session. My insurance did pay for the initial blood tests, EKG, etc.

I think the chamber works pretty good.

Good luck with your sessions,

ljoy's picture
Posts: 94
Joined: Dec 2007

Had my annual checkup with ENT today. He put tubes in my ears due to fluid in the ears and not clearing from Hyperbaric treatment. It was a simple in office procedure with local anesthetic. It was immediate relief. No big deal. I finished #10 treatment this morning.

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