So my husband Michael went for a root canal on April 12 and one extraction on April 13. He had the twenty hyperbaric treatments prior to them and 10 afterwards. We had thought everything was healing up all right although he did not have many follow �up dental visits scheduled with any of the four separate dentists involved in his care,. About 2 weeks ago he had some swelling again and he went back to his regular dentist and he told him that the tooth with the root canal was infected and the tooth is loose. He put him on antibiotics, the swelling did get better, he went back to the dentist this past Monday and he told him that it looked better, but still not totally healed. Today he woke up with a mouth full of blood. He really doesn't know exactly what is bleeding. He is scared and I am scared. He goes back to the dentist today in a couple hours. Any thoughts, reassurance, whatever???

Yikes... Maybe there was puss or something inside the root area and this caused the bleeding... Gums are sensitive. There are a few people here who know lot about dentistry. Thru can probably give you better in site but I would say it's likely the infection TTY not to freak.. Radiation is unkind as you know healing is hard. Sending you blessings.

Thanks for the in-put and good wishes. Michael went to the dentist this morning and the dentist says it is infected worse than it was Monday when he saw him last time. Monday the dentist said it was getting better, but now is worse again. He put him on yet another antibiotic. He was on amoxicillin for 10 days (last day was Monday) and now he is on augementin. These local dentists here do NOT seem to know a lot about oral cancer patients and their problems. I do have a call into his oncologist who we pretty much trust. I do worry too about all the different rounds of antibiotics he has been on since the cancer for various things. Just when we are getting semi close to that five year mark more problems are coming up. Just want him to feel better and my stomach to stop hurting also. Thanks again.

Does your hospital have dental oncologists? Maybe transfer there - we have them at pmh... I get a checkup every few months. They will do any complicated care as well. And since it's a cancer hospital they are well versed in working with OC patients. Good luck!

Hi,
My husband is a general practice dentist. Part of being a competent generalist is to know when to pass on issues. He has no problems referring people on to specialists, but I do know GP dentists who try to do it all. My having gone through oral cancer treatment has given him a special knowledge of the subject, but he does not feel comfortable with treating me for major problems with my teeth. Luckily for both of us, major problems with my teeth have not ever been an issue.

Those dentists associated with cancer centers are the ones to be seeing, but I know if you are a distance away that can be a problem. Contact your ENT or if you have seen any dentist at a cancer center, you might be able to contact them first.

Hope you can get this resolved very soon, not anything to mess around with.
Best,
Anne

Thanks for your responses. So I was finally able to talk with the oncologist�s nurse yesterday about 2:30 and the oncologist was already gone for the day and he is always off Fridays so he wasn�t available. The nurse seemed to think he would defer to the dentist�s opinion. I did ask the oncologist�s nurse about the hyperbaric treatment again and she just told me to talk with the hyperbaric doctor again. I know my husband really did not like the hyperbaric treatment and he feels his hearing and vision have still not recovered fully. I tried to call hyperbaric doctor and he was also gone for the day. It is just really scary and my husband who is usually the calmer of us was also really pretty upset about the whole thing. He sees the dentist again on 8/2 and we are supposed to go away next weekend before then so it won�t be too much fun with this hanging over us. He just finished the last round of antibiotics on Monday, saw the dentist Monday and the dentist thought it looked better, and by yesterday, Thursday the infection was back and worse with the bleeding. We live on the Gulf Coast of MS ( I am previously from outside Buffalo, NY and my husband is from MO) with not a lot of specialists available here in any areas. We went to MD Anderson at the beginning for a second opinion and their dentist thought his teeth looked good at that time. Just hope we are doing everything we should to get rid of this infection at this point.

After someone has had radiation they must be obsessive with their dental care. Having a drier mouth is one of the after effects most of us suffer from. A dry mouth also makes it easier for infections to begin. Ive done many HBO's and wouldnt think this is an instance for it. HBO is normally used for healing lingering wounds and to prevent osteoradionecrosis. A strong antibiotic should take care of an infection. Does your husband have an ENT or oral surgeon? Maybe seeing one of those doctors would be beneficial. Best of luck with this problem.

I'm with Christine about being obsessive w/dental care. His teeth may have looked good at one point, but I guess that was before treatment? The oncology dentists at MDA definitely know what they are doing, if it is not too far it would be worth going back to them. Folks like your husband are the only patients they see!

Depends on the oral surgeon how many oral cancer patients they see; often they are only seeing them at the beginning of treatment, such as when they biopsy. If it is a root canal was he not seeing an endodontist? Radiation makes it all different. They probably have some patients who have had radiation, but do not have the expertise of oncology dentists, how could they? Root canal procedure can go sour sometimes even when the patient has not been through radiation therapy.

You and your husband know your situation and have to make your own decisions.
Best,
Anne

Thanks for the in � put. He does have an ENT, oral surgeon, two endodontists � one who did the root canal and one who cleans his teeth, a regular dentist � who is seeing him now and of course the oncologist. He also has a primary doctor at the VA � who basically just prescribes cholesterol meds for him and shows him his dog�s latest pictures. He really did not like the oral surgeon and I didn�t either. He had a general anesthetic for the extraction and he was barely conscious when they came to get me to send him out the back door and home with me. He could barely walk. The oral surgeon also did NO follow up. If he ever needs another extraction we are going to see someone different. Unfortunately down here on this MS Gulf Coast there are not a lot of choices for specialists in any medical areas. Michael likes his regular dentist and the two endodontists. I just am hoping the current antibiotic works. He is pretty good I think about his dental care after all of cancer issues. It just seemed weird to us that three + months after the extraction it would get infected. I gather all the bleeding yesterday really was scary to him and I know hearing about it while I was at work was to me. I may still call the hyperbaric doctor just to ask. Michael isn�t really fond of the ENT either since he has been the source of several post treatment �false alarms� and has also scared us and we know that he and the oncologist frequently don�t agree on things and the oncologist is the one we both trust the most. Thanks again.

Barbara,
Our previously radiated mouths just do not respond the same way unradiated mouths do. It sounds to me like you and your husband, and perhaps the dentist(s) are not certain if it is the extraction or the root canal that is causing the problem. I guess if it were me I would consult with the doc you most respect/trust, and ask them what you should do, although I don't know how much your oncologist likes to mess with dental matters. Still would not hurt to ask them for guidance. And maybe the antibiotic will finally prevail, it happens.
Anne

In rereading your previous post, I saw that you did consult the oncologist & the nurse though he would not want to mess with dentistry. So sorry, I got confused with all the doctors--I have the same situation in my life now! So seems like your options are go somewhere else in dentistry, getting another opinion (like MD Anderson) or stay the course where you are, at least for a little while longer. Sorry for the confusion.