I finished my treatments in June '07. I had my teeth checked before treatments and my dentist said I should be ok to go ahead with the radiation/chemo without needing any prior dental work.
Well, a month and a half ago I needed a small surface cavity filled on the outside of one of my lower molars. Other than a little soreness, I experienced no problems with it until...about three weeks ago I was chewing some gum and all of a sudden the back half of that same tooth just broke off!
I went back to my dentist and he said it would be best to try and save the tooth instead of pulling it, but he wouldn't touch it. Instead, he referred me to a specialist (endodontist).
Today I saw the endodontist and he told me that he would do the root canal but that I would have to take antibiotics prior to the procedure and after the procedure. He also said that if the root canal doesn't "take", then I would probably need HBO treatments and may need a referral to an oral surgeon to pull the tooth.
I'm sure some of you may have experienced this complex journey involving dental care, but this is a first for me. I am just very scared that I will not only lose my teeth, but that I will end up with all the serious problems that come with it concerning the jaw bone, etc.
Sorry for the long story, but I just felt the need to express my concerns and was hoping that some of you could share your experiences and insight.
DR. MIKE...HELP!!!

Good morning x28007 When I was first told I had the C word my radiation sent me back to my dentist to have teeth removed that wee bad. He pulled all but four. I came on here this morning to find an answer to one of my questions. My dentist told me that after the radiation I could not have the four removed for a long time because it would cause me medical problems. Howere the Radiation totally destroyed those four teeth and I am in constant pain and was wondering how long I wouold have to wait to have them removed. maybe we will both get an answer. Good luck. Keep me posted on what they decide what to do about your problem. I hope you are able to keep your teeth. My gums are shrinking as well as my jaws and it hurts. i am calling my dentist to see what I need to do. I know I didn't answer your question but as I said maybe we both will get an answer. Brenda

My story is similar to both of yours. Went to dentist prior to rad. After rad teeth werent good. Mine are all loose and uncomfortable. Anyway, Ive been doing HBO. I had alot of jaw pain daily which is now completely gone. Ive done 43 dives with 7 more to go. Most docs/dentists will tell you that you need 20 dives before dental work and 10 after. HBO is a breeze compared to any of the other treatents Ive had. It has worked wonders for me and I cant say enough good things about it. Thats coming for a skeptic of any unorthodox treatment. HBO is very expensive and most insurances will have to preapprove it.

There is a lengthy post about HBO on the forum, check that out too. Hope that helps you both.

I just started my rad Txs yesterday and I had a lot of dental questions...I always do. My teeth were checked by my Dentist and he said all was good. I also had a second opinion by a Periodontist that is familiar with rad Txs double-check...all was good. My main concern is what would happen if I need dental work down the road. My Radiologist told me if that happens make sure you see someone who knows about radiation and OC. And to have that Doctor call him and they would discuss the procedures to take. My Radiologist said most likely HBO txs before and after dental work. He also told me I will have to maintain excellent oral hygiene for the rest of my life. I was also told if I ever have a filling or any other kind of dental work that I should get new fluoride trays made in order to fit properly. I also asked what would happen if I start loosing my teeth 30 yrs down the road...he said I can't answer that because by that time medicine will be different. Good luck...we all need it.

I'll try to adress all of your questions.

You don't mention if you are using fluoride. This is important of the future health of your teeeth.

You also didn't mention if your dentist thought that the tooth fracturing had anything to do with your radiation. Many teeth break in people that have never had radiation. I sometimes see 2 or 3 people a day that have this happen. It just may be coincidental.

It is not unusal for a dentist to prescribe antibiotics before, during and after endodontic treatment. Again it has nothing to do with why the treatment is needed. The endodontist's recommendation that you would need HBO treatment if the tooth needs extraction is right on the money. This is to prevent you from having a healing problem after the extraction. The problem is called osteoradionecrosis (ORN)and you can search this site for more information on it.

There are many people here that have kept all their teeth during and after treatment. Diligent homecare, fluoride applications and frequent visits to your dentist will help you keep them. The fact that your teeth were healthy before treatmetn, gives you a good chance of keeping them if you follow all the rules.

Jerry

What is HBO? My husband will soon be seeing a different dentist regarding his teeth.

Ken's wife

even i want to know what is HBO

HBO = Hyperbaric Oxygen treatments.

I started using my trays 1 month before radiation; I used them almost every day during Tx and I have used them every day post Tx now for OVER, emphasis on OVER, 2 years. I just recently had a very small cavity, first one in maybe 20 years, filled and I had no issues whatsoever. My dentist of 25 years says my teeth look as good now as they ever have so I'm naturally a advocate of continuing good dental hygiene.

I worried about my teeth when they started to fall out for no reason and break off. Now I am not saying I don't miss having them, but the Drs took them for rad seed implants, radiation and chemo treatments. I sure hope you can keep your teeth and enjoy eating like a normal person. I hope noone else in here has to lose theirs. It's hard to live not eating chewable food and there is no daylight in site for when I can get dentures. Good luck and I pray ypou keep thos teeth.

Jerry,
Thanks for your reply.

Other than flouride toothpaste, I am not using any other flouride. I plan on requesting the flouride trays from my dentist when I see him in a few weeks though. I wonder why my dentist never suggested the flouride trays? Anyway, do the flouride trays need to be custom made? The ones they use in the dentist office are not custom, so I was just wondering.

As far as the broken tooth...neither dentist said that the fracture was caused by the radiation. Personally I think it was because the tooth may have cracked when my dentist filled it a few weeks prior to the fracture, but we can't know for sure.

My trays were molded to fit my teeth and they fit perfectly until a month ago when I left them out one night and one of my cats took them all over the house. It took me 2 days to find them and they are not quite the same now but I'm still using them. Guess I'm lucky one of the cats found them as my puppy would have just eaten them.

Yes, you should have custom trays made.

It would be unusual for a tooth to crack when a "small surface filling" is done. Teeth can have hidden fractures in them that even a dentist won't see and they don't show on x-rays. All it takes is biting on something hard to cause a tooth to break. Fractures can go undetected for years. Also chewing on ice can lead to fractures in the enamel.

Ken's wife & Samta,

You will find a great deal of information on this website by using the search fields at the top of this page and on the home page by typing in HBO or the full name.

Jerry

In the office they likely use one size fitz all, but you want the custom made ones to ensure they fit well and keep the fluoride in the right place (I find that I can get the paste or gel into the silicone trays just right and not have the stuf all over my mouth).

I agree with my wonderful colleague on the undetected fracture it is a common phenomenon that is very hard to diagnose let alone see (probably more undected ones in Jerry's practice with his age and failing eyesight, sometimers disease,...sorry Jerry just had too..)There is however a way that I have used on many occasions to determine if the tooth is, in fact fractured. Think of the small filling as the wedge in the wood that you bang on to split it. The forces applied to the wedge make it much easier to split the larger piece into smaller pieces. So...when you bite on this small filling if the bite is not perfect it puts adverse forces on the rest of the tooth. When the tooth starts to flex to the point where the stress is beyond normal the patient gets a sharp stabbing pain or "zing" in the tooth and subsequently doesn't chew on it (..and then blames the dentist for practicing substandard ...never mind). If a dentist cements a properly fitted orthodontic band around the circumference of the tooth all the adverse forces are directed down the root of the tooth and viola no more pain. If pain remains then I would suspect that a root canal or extraction would be in order. If the pain goes away the band can remain almost indefinately or a crown can be placed on the tooth.

Wow...I can certainly make a short story long...sorry..but you get the idea.
Cheers,
Mike

[size:20pt] Mike,

Could you use a larger font please?

Jerry[/size]

Love the way you guys provide a little light hearted entertainment in between reading all the sad stuff here

Haaaa Haaaaa. Ohhhh myyy ribs ...Jerry you kill me ...now my wife is wondering if the medication will ever work. Me sitting here typing and laughing at the screen.

Jerry...where are the big keys that make the letters that big...Oh yeah we don't have those in Canada.
Cheers folks I'll be here all week. Try the chicken.

Mike

Gabe,

When you spend most of your day "looking down in the mouth" and often hearing "I hate dentists", you have to have a good sense of humor. However, I try not to make my patients laugh when I have my fingers in their mouth.

Jerry

Wow you guys are playing in a whole different field I had all my teeth removed over 6 years ago...should have been a sign then but my doctor told me that cause I had no teeth it helped saved my jaw bones prevented the cancer or took it longer to get to the bone. In any case true or not not sure but it is what I was told.

This experience not having teeth is well been a little bit easier can't expect to eat a big steak don't so don't miss it...my dentures are very comfortable and very functionable although not sure what way we are going to go now........I just know there was no more pain but I do understand having one's own teeth...If you can keep them awesome but just from the other side of the fence they ain't that bad...

Dianne

Dianne,
Understanding that you now have dentures, whether there were other options or not, you now have to move forward with them. There is really no reason why a good, functional and comfortably fitting denture should prevent you from eating a steak, apple or corn on the cob. You just have to adapt to the way they work.
If, after much perserverance, you find yourself unable to accomplish eating and enjoying these foods you should probably consult the dentist who constructed them to see if they can be adjusted to accomodate the situation. If the answer is they cannot then you may want to consider having implants placed to support and anchor the dentures in your mouth so that they do not move or slip when you eat. Your existing dentures can easily be secured to implants without having new ones constructed.
After all, eating is one of the simple pleasures of life and being a denture wearer should not deprive you of this. You just have to know what options are available.
All the best.
Mike

Jerry, Mike's posts are coming to me in the same size font as most everybody else's (not counting your recent one, of course!).

Ditto - Mike's font size on my computer looks just lie everyone else's

[quote=Dr. Mike]I agree with my wonderful colleague on the undetected fracture it is a common phenomenon that is very hard to diagnose let alone see (probably more undected ones in Jerry's practice with his age and failing eyesight, sometimers disease,...sorry Jerry just had too..)Cheers,Mike [/quote]

Mean't as a payback no doubt

Sorry folks...I was just being me my computer works fine and I know where the big keys are.
No payback, just a playful attempt at honoring my wonderful colleagues long career in our profession. I have an off beat sense of humor and Jerry has been aware of the circumstances that have recently unleashed it. I was poking fun at his upcoming retirement from full time practice and as he knows giving him my respect.
Jerry is a champion of our craft, a great mentor for me to look up to, and a friend that I hope to meet in person someday.
My humor should be left at just that, humor...so where are the big keys?
Cheers all,
Mike

I guess since I was away yesterday, Mike and Gabe got to clear up the little bit of humor that Mike and I have been going back and forth with.

If you've never been to a dentist with some sort of sense of humor, you haven't lived. I've only lost one finger in 38 years and that happened when I slipped and told a joke while my fingers were in somone's mouth.

Jerry

Jerry,

When I moved to Los Angeles, I found a wonderful dentist, right on the edge of Beverley Hills. He had a great sense of humor, but I suspect most of his patients didn't. After my x-rays revealed a lack of wisdom teeth I looked him straight in the eye and said, "Well, no wonder I'm so stupid!" Both he and his assistant started to tell me there was no connection between IQ and wisdom teeth before they realized I was joking. After that, I always got at least one good laugh at every appointment

I have done a search for HBO please tell me what it is? I was left with four teeth in my mouth and they look horrible and hurt like the dickens. I want to have them pulled but have no money for the dentist. I am struggling to pay him for the work he did one year ago. I still owe him over 1000.00 he so far has been good about it. But I need some relief and I read hee a little about HBO but am still blind.