Hi Everyone,

My 2 surgeries, followed by 33 radiation tx with 3 chemo tx prompted me to write last time. The recovery was uphill & frustrating, so I went to a denturist and was fitted with a bottom plate (5 weeks after the final radiation treatment).
Having the option to wear teeth made me feel a lot better! but then on my first check-up by the surgeons & Rad Dr.s, I was told the plate would interfere with the healing. So until the next check-up I only wore the plate occasionally, (eating solid food carefully with knife & fork etc.).
My next check-up with all the doctors was good! I was healing fine, even the oral surgeon said it's OK to have the bottom denture realigned by the denturist. So I did.
Well my last check, the surgeon exclaimed I had 'Stage 1 Osteonecrosis'! and immediately referred me back to the oral surgeon/dentist at Sunnybrook Health Sciences Centre in Toronto, Ont.
OK, so, what now?
I am advised to stop wearing my bottom denture, eat only soft food and come back in 3 weeks. I probably have to set aside 3 months for the medical establishment in Ontario, Canada to provide treatment.
They are a little vague about what that involves, however my understanding is HBO followed by more surgery.

I am just realizing that radiation treatment slows (or obstructs) normal healing, (no one mentioned this before I had it done!).

I am going to investigate alternative advice, I don't want to be laid up in a "Learning Hospital", again.

At this stage, I am not wearing the bottom denture plate, and I have stepped back, I am reassessing the whole situation.

Any advice would be helpful. I seem to be clear of cancer, (Yippee), but the bottom jaw is deteriorating and I have to deal with it sooner or later, I am adverse to going back to the Hospital/University that made treatment more aggravating! (by allowing students to look at me all the time!).

Should I seek a second opinion from a hospital in the USA? (which one?, I am in Toronto Ontario Canada).

thanks for listening;
Doug

Doug,
Hi, a little uncertainty and a minor setback has seemed to come your way. Lets forget about the fact that you weren't told about the possibility of bone deterioration and be thankful that the cancer is gone!!
Osteoradionecrosis is a condition caused by radiation therapy. Basically the cells responsible for producing and strengthening bone die and an area of bone void of nutrition becomes necrotic. Left alone the enzymes produced by the dead bone will cause more bone to die. Stimulating factors such as wearing a denture can put pressure on the bone and potentially worsen the problem.
Solution: remove the necrotic bone this is usually preceeded by hyberbaric oxygen treatment (dives) then surgery and the on occasion during healing more dives are needed. Toronto has good facilities for this type of treatment but the wait as you post is a little long. Having not evaluated you and or your x-rays by the sounds of things your doc's got it right.
Your decision is whether to seek quicker treatment in the US. I am unable to advise you on this because that is soley a decision you need to make and then discuss with your docs.
I hope all goes well and pray for a quick recovery for you no matter where you choose to have this looked after.
Cheers,
Mike

I can give you a little HBO info. Ive done 125 dives over the past few years. HBO can be very time consuming. It takes aprox 2 1/2 hrs daily Mon-Fri for treatments. The tech takes your vitals, you must change your clothes, get settled in the glass tank and stay there for aprox 2 hours, then more vitals signs and change clothes again. If anyone who has appointments before you is diabetic or has trouble 'going down' that could push your appointment back a half hour or more making it an even longer appointment. During my HBO treatments, it felt like I had a full time job just going to HBO.

HBO facilities are not in every hospital. In my area, the largest hospital does not even offer it. Also, the cost per dive here runs at the lowest $450 per dive. Most are $700 or more. Most HBO therapies will be given in 20-40 sessions which makes it one expensive procedure! Luckily my health insurance covered it all for me. Hope this info helps yout to decide in making your decision to seek treatment in the US.

Thanks for the advice. It's hard for me to think of the situation as a "a little uncertainty and a minor setback", however I will continue to struggle along.

Thanks for the heads up about the Hyperbaric Oxygen treatments. I had no idea they were so involved or expensive!

I just have to wait & find out what the Dr. thinks when I see him again Oct. 12th. I'll have been eating soft food and NOT wearing my false teeth for 3 weeks then, hopefully some healing has occurred. That would enable me to delay longer.

Thanks again,
Doug

Thought I'd change my mood ICON, it seems you must change it before you post.

Live & learn

Well, reading this was interesting to me. I have been concerned about this as well. I have four loose teeth in the front and gum recession. It looks like I am headed down that path. My periodontist is doing everything he can to keep from going down that path. Radiation: The gift that keeps on giving. Not thankful for that gift at all.