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My husband (BOT SCC--finished treatment June 04) has had HBO treatments and after that a round of CIPRO (antibiotic)& finally acheived healing of exposed jawbone after 18 months of waiting. (Bone was exposed due to tooth extraction done just 5 days prior to start of radiation.) We had just about given up on healing and were very concerned about his pain and narcotic use. Things were looking great for several weeks after the eventual healing, but several weeks ago, a strange looking area has appeared in his mouth. Looks like a raw place and has a white cover/"skin" over it until washed away with syringe (no needle)and water. Goes to doctor on June 12 and may have to have another biopsy to check it out. Afraid they may decide this is bone death/ORN and procede w/ jaw replacement OR that it might be recurrance of cancer. Anyone had this problem?

This sounds like thrush to me. Ask about Nystatin liquid swish.

I had something similar after having two molars removed and the cortex of my mandible thinned during surgery. Had exposed bone for about a year and a half and still have a little around the last tooth on that side of my mouth after 24 months.

The ENT would see little slivers of bone (he called them spicules) either exposed bone from lack of adequate skin cover or sticking through the thin layer of skin covering the mandible. He'd take a big plier looking thing, reach in and snip a piece of mandible and some skin. Said that this was a good way to promote and speed up healing. It took about 18 months of repeating this process until it stopped. He biopsied every little sliver he removed, saying that as a general rule, anything that came out of my mouth was to be biopsied. So another biopsy for your husband could be a very trivial process if it is even needed.

Since it was dead bone, it wasn't going to do any good staying there. It was by biopsying the piece of removed bone that an infection was discoverd and successfully treated with antibiotics.

While your descripton of the white covering could very well be thrush, it is possible that there is more than one thing going on and you should ask your doc on the 12th what his plan is, how often this should be checked, what the possibilities are and what treatment options exist.

You will know more in a few days and it could very well be something that is easily treated.
Best, Sheldon