Hi everyone,

I am now 14 months post surgery, and 11 months post radiation treatments.

For many months now I have had problems with my lower teeth. My jaw aches all the time, and 4 teeth are very loose. My gums have also receeded a lot, and frankly it looks hideous - not to mention the pain and discomfort.

Then this week my face and neck swelled up so much that I looked like Marlon Brando in the Godfather!! Having returned to see my surgeon and had x-rays, they are telling me that it looks like I have 3 or 4 absesses in my jaw. This is very painful, so I'm back to not eating......

I am on medication to treat the infection, and have to return next week. They tell me that I have 6 dead teeth on the bottom, probably due to the radiation treatments. It looks like these will have to come out, and I have to decide what I want to do in terms of replacing them.

I am told that I cannot have screw in teeth as the jawbone will not hold them, so my option is to have false teeth on a plate.

I know that I should not worry about this, and should be thankful simply to be surviving, but I feel that my realtionship with my husband might suffer. I just cannot even imagine what it would be like to kiss with missing teeth.

I know that some of you have had dental work done post radiation, and would welcome any advice - either about what work I could have done, or about relationship/kissing issues for gummy persons!!

I had my teeth removed pre-treatment. My dentist removed all my teeth except 12 incisors. I am to see my dentist Monday the 15th about getting a rubber prosthetic device. Implants are not an option until at least 3 years after radiation treatments.
I know very little about this rubber prosthetic device but as I understand it's application it anchors like a bridge and has no full plate covering the palate.
I will let you know when I know more about he device.
Darrell

Thank you Darrell.
I will be very interested to know what this rubber device is. I am told that I cannot have a bridge due to the damage it will cause to existing healthy teeth. I am not sure if we have these items you mention here in the UK, but if you can find out what it is called I can ask my surgeon.

Debbie, I had two mollars pulled in the right side of my mouth (#3,33) before rad/chemo. I will be getting bridges for both before the end of the year. In addition, like you I had damage to the gums and teeth in the bottom middle incisors. All 4 need to be pulled and I will also have a bridge for those. Why won't your dentist do a bridge? The healthy teeth are just filed down to allow the bridge to fit on them. I have a bridge already on the top left side all the way around to the top right middle (three teeth to the right of the center line). No problems with any of this. I can't imagine why there is concern of damage to the healthy teeth. You might want to get a second opinion on that.

I lost the left bottom teeth when that part of my jawbone was removed and I am going to have implants. I don't understand why some people are told they cannot have these? I have spoken with a man in my area that had the implants done, top AND bottom, and he had radiation. Another poster on here, Joanne, has had implants.
When I was given all the options, implants seemed to be able to make my mouth closer to normal.
Minnie

Minnie is talking about me. Just a few months post rad, my bottom front teeth began to break off. They were very dead. I had hyperbaric oxygen treatments which caused new capillaries to form in the radiated mandible. 30 treatments, then the implant bases were inserted into the bone. This was followed by 10 more HBO treatments. The oral surgeon said that after the HBO, the bone bled just like unradiated bone. At the end of this month I will see the dentist for molds for the permanent implants, which are some kind of a bridge which screws onto the implanted posts. I have all this time had an upper plate. I am so used to it that even though I said I was going to get upper implants too, I may not as it works very well and I am just not aware of it now. Because two of the original five implants failed to integrate, they were redone and the clock was set for another six months. The dentist took pity on me and fashioned some faux bottom teeth which snap on over the posts. These, with the upper plate, look much better than my real teeth ever did. I am not supposed to chew with these, otherwise I would be happy to just keep what I have. And yes, one can kiss quite nicely with these faux teeth (grin). Ask your dentist or radiation oncologist for a referral to a dentist who specializes in implants. A friend, who had no radiation, just bad, bad teeth, had her weak jaw built up with some powdered bone so she could support implants, and she has had a mouth full of them for five years. The message here, is not to give up!

Thank you so much everyone! I will ask my surgeon and dentist again - and in a lot more detail. Sometimes it is just knowing how to challenge them by asking the right questions isn't it?

I most certainly will not give up!!

Hi, My husband had nasopharynx cancer and is eleven months post radiation. All of his teeth have decayed from radiation and he needed to have them all pulled out two weeks ago. He had 20 hyperbaric treatments before surgery and 10 treatments after. Implants have been mentioned but oral surgeon and radiation oncologist say not right now. Try dentures first, implants can always come later. There is a risk of infection with implants which I think my husband is not willing to take at this time.. He will go next week to talk about treatment plan and get fitted for dentures. HBO treatments seem to do the job of helping the gums heal. He had no trouble healing. Eileen

You need to see a maxillofacial prosthodontist that preferably also specializes in patients who have had cancer. I had my 16 rear teeth pulled to radiation. I now have two partials. They capped my 4 eye teeth(insisors?) and there is a ball and pin snap device on the back of each cap that the partials snap into. There are quite comfortable and have the advantage of starting my saliva production when I pop them in in the morning. You're not supposed to wear them to bed. He would like me ot get implants, but thus far, I am happy with these for the last 6 years. As to kissing, nothing has changed for me and hubby hasn't said anything.

Took me four prosthodontists before I found one who would even consider making me teeth and he didn't think it was any problem, but he deals with complicated cancer cases as his stock in trade. So don't give up, you just need to find the right guy.

Take care,
Eileen

My understanding of the reluctance of some oral surgeons to attempt implants in radiated tissue is twofold. One, the blood supply to radiated areas is compromised and gets worse over time. Two, it is more difficutl to watch for recurrence with implants.

It is good to hear about Joanna's experience with HBO treatments. Sounds like that is something that would benefit all radiated oral cancer patients.

I was told to wait at least 2 years post Tx before even thinking of implants. I'm now thinking about a bridge instead. - Sheldon

Sheldon, you bring up a good point about checking for recurrence. The bridge I will have is not supposed to be removable by me, but the ENT/oral surgeon/dentist who is taking care of me can remove it to check me out. I suspect with a little practice, I will be able to get it off and on too. No way would I want to permanently cover up that area! I found the first occurrence, and I am now watchful. If you have teeth to hook it to, I think a bridge is a much better, and far less expensive solution.

My husband`s dentist has recommended he get crowns, 5 bottom front. He already has a mouthful..and the appointment is for next week. I am not too sure if this is a good idea if the teeth are going to keep on deteriorating. Whats your advice guys?
Marica

Hi Guys, I have a question about HBO treatment. I have a tooth that has had two root canals done on it and it doesn't seem to be healing properly,etc. HBO was mentioned to me by my oral surgeon, in fact, he told me to ask the dentist doing the root canal to try and save the tooth if at all possible. Is the HBO necessary after radiation treatment in all cases? And is it only when you have teeth pulled? I still don't quite understand it. Thanks so much!!!

Carol, radiation to the jaw severely reduces the blood supply in that bone, so if there is trauma to it, such as extraction, it may not heal. What is to be avoided at all costs is the dreaded Osteoradionecrosis -- bone death due to radiation. The is where HBO comes in. The increased oxygen causes new capillaries to form, which allows the bone to heal from extractions or other trauma. It is only my opinion, but I think it would be great if everyone could have HBO post rad, but as it is very expensive and time consuming, I doubt that will happen anytime soon. This is just a simple overview. You can search the net for more extensive information.

Thank You Joanna, that explanation helps. I am praying I won't lose the tooth in question or any others, but I take it all One Day at a Time. That is really all that any of us can do!! SMILE!!! Thanks again for your reply...God Bless, Carol