My husband is about to have his first dental cleaning appointment since his treatment (IMRT + Cisplatin). Is there anything we should be asking the dentist? Should he be seeing his regular dentist or a specialist? Is there such a thing as a oral cancer dentist? I am terrified of him getting an infection because a hygienist is over zealous.

anemone,

The only thing I did was to let my hygienist know that I was a oral cancer patient. I let her know that my mouth was tender, and had dry mouth.

This way she would go easy and let me have water break off and on. The first visit was OK, but the 2nd was much better.

Take care,
Diane

Where I was treated (the Tom Baker Cancer Center in Calgary, Canada) they have a dental oncology department. They deal with head and neck cancer patients almost exclusively. Every check-up includes a visit to the dentist. Given all of the potential problems that exist with inadvertant injury to the inside of my mouth, I don't have ANYTHING done by anyone, without checking with them first.

I have a relative who is an oral surgeon...we're very close, and I trust him totally. He will be doing all of the restorative work (titanium implants) for me, however he will not do a thing without running it by the dental specialists at the Cancer center.

Personally, I think it's really risky to let someone who isn't fully conversant with the issues that oral cancer presents do any work. Have you checked with your MO/RO about local dentists they work with?
Wayne

Anemone,

I had my teeth cleaned 4 weeks post Tx by my regular dentist. I see him 4 times a year because I have alwaqys been protective of my teeth, etc. He was aware of my Tx and did my pre Tx checkup and took out some old fillings and replaced them. He is aware of OC dental related problems and I trust him a lot.

My cleaning/checkup went great. I had been brushing, flossing and using fluoride daily throughout my Tx and my dentist even started me on the fluoride 1 month before my Tx began.

I discussed the potential for bone decay due to the Rad and he told me, in addition to continuing the fluoride, that keeping my mouth as moist as possible until my salava returns is very important in preventing the decay.

I was offered the dental services of Moffitt Cancer Institute before Tx began but declined. Check your dentist out and go where you feel the most comfortable.

I went to my regular dentist and he was already informed about my treatments before I had started. I was told by him, and also my RO had told me, anytime I was to have something done on my teeth to take antibiotics before I went in. The dentist even subscribed them to me when I had my first cleaning, just as a precautionary. He said anytime there could be bleeding is a good idea to take them.

My husband's dental oncologist at Johns Hopkins called my husband's regular dentist after Barry was through treatment, and they discussed "what you can do and what I (the dental onc) should do." He also filled the dentist in on some "red flags" to watch for, and gave him a few references on dental impacts of HNC radiation therapy.

Essentially, he said the regular dentist can do cleanings, fillings, and other routine care that does not involve dental surgery. We asked the dental onc about root canals, should one be needed, and he indicated he would like to be notified but that he felt the regular dentist could probably do one with appropriate precautions.

Barry's teeth came through radiation in good shape and he is meticulous about care, cleanings 4x a year and daily application of fluoride trays. He also uses dental gum (Xylimax, which increases mouth moisture and also helps prevent cavities). Barry is one year+ out from treatment, & saw dental oncologist for a 6-month check-up just last month and he was very pleased with his dental condition but we know it requires constant vigilance.

Gail