I discovered today that an abcess on my gum was caused by a broken root on my molar. The molar was "ground zero" in the field of my radiation, 3 years ago. Has anyone had to have a tooth pulled, post radiation? Did you need to spend many sessions in a hypobaric chamber both before and after the tooth was pulled? Can the tooth be repalced with an implant, or does it need to be a bridge. I have an appointment Wed. with an Oral Surgeon and would like to be prepared with questions. Thanks for the help.
Rob J.

I wouldn't do this with out the 02 treatments. That is courting a new problem that is really bad. After the treatments and the extraction site has healed, and implant is an option, but they are not as successful in radiated bone as in normal bone. A three unit bride has issues, but they are not failure of the bridge. Implant failure means that you will have a non healing hole there again, and 02 treatments again just to get back to square one. If your dentist has questions about this have him call me. There are other factors that predict implant successful osseointegraton in the bone or not, you also want to rule out all those mitigating factors.

Brian,
Thanks for the quick answer. That is what the doc(s) suggest. I'm only questioning because my agenda and the Docs are not always the same. Would it be worth trying to do an implant first and see if it takes? Does 20 times before, and 10 times after extraction sound correct for the hypobaric chamber.
All the best in the new year,
Rob

Rob,
I had a tooth pulled after radiation, it too got the full radiation dose. I did not have HYPERbaric treatments especially for it but I did have 30 dives about 4 months prior to the extraction. Make however sure that you are dealing with and experienced person! Although things healed up ok, I ended up having a fistula between mouth and sinus cavity which was weird and took several months to close. It would have been so much easier to just put one stitch in. I was contemplating an implant too, but then it was just tooth #2 and therefore not a functional nor a cosmetic issue and in the end it was simply not worth the risk. IF I ever consider an implant (elsewhere) I only would do this with a person that has extensive experience dealing with OC radiation patients.

M

Its very common for dental procedures to require 20 HBO dives prior to dental work and 10 after.

Pete just had a tooth pulled a few weeks ago, top row
second from back, this tooth aready had root canal and crown. It had abcessed. It appears to have healed OK. His dentist wants to put in a 3 unit bridge to stop the remaining teeth twisting. He is 62 and we have more equity in his mouth than the house!

I am wondering what the issues are Brian?
Marica

If the implant does not integrate, you are back in the 02 chamber to get that site to heal up again, essentially $ and months into it and still at square one. Bridges have been useful for many many decades, only in the last 20 years have implants become an alternative. If you keep a well designed bridge clean, (one that has few food traps) it will service you the rest of your life. Is it a cool as getting an implant, no. I designed implants and their abutments etc, for most of my life, I love implants and the science behind them.

But in radiated bone the results are not stellar. Perhaps if that area of you mouth got little radiation because of IMRT, I would change my mind. Or if you just get off on sitting in 02 and reading, have the time on your hands, you can take the shot. The positive to the implant is that it is not going to require the cutting down of the tooth adjacent to to the missing tooth on each side. So the last consideration in my mind would be what are those teeth like? If they are crowned already, have big restorations in them, or even caries etc. cutting them down is not destroying healthy virgin dentition to be the abutments for the bridge. In that case cut away.

I would recommend the HBOT treatment. I have started doing the treatments in December. I was trying to get 20 dives in before my implants. But I only got 11 in before the implants.

Plus when I seen the dentist last week he had to pull two teeth on my due to bone loss. I wish I would have know all the dental nightmares I have gone through. I have a great dentist up in Utah and he been learning a lot with my on having Oral Cancer. We talk about things and he checks things with my Oral surgeon since my oral surgeon deals a lot with oral cancer patients.

I just had 6 implants but in yesterday and so 9 teeth have been caped, 5 teeth prep for new caps and two teeth that were pulled will be set up for a bridge.

This is a great site to find you answers to your question.

Thank you all for the input. I found an Oral Surgeon with alot of OC experience. I will be starting my 20 dives next week (2 hours per) then 10 dives after. He expects to be able to do an implant if the bone heals the way that he expects.
All the best in the New Year,
Rob Jaffe

Hello to all. This look's like the site that can help me?. I had scc about 13 yrs ago. I had the tumor under the left jaw removed and radiation. I have now a painful tooth that needs to be removed but the oral surgeon is afraid to because of the possible complications involved.I have been in pain since Thursday night and I don't know what I can do?. Any suggestions would be very helpful. Thanks