Hello there,

I am reaching out because my mother had a dental check up at Sloan and it was discovered she has "extensive tooth decay through her mouth." (Somehow her regular dentist who she sees every 3 months seemed to miss the decay, but that's another story. And she usually only goes to Sloan for an annual check-up. )

She underwent surgery and radiation treatment in the spring/summer of 2011. She had a good amount of her hard and soft palate removed, along with a salivary gland or two, a few teeth, and lymph nodes in the left side her neck. She wears an obturator and has limited capacity to open her mouth due to radiation treatment. (She had the surgery done at Sloan in 2011 but the radiation elswhere).

Sloan advised her she had extensive tooth decay and that their staff could address the decay in her mouth but she is 77 and was told multiple visits to Sloan would be necessary to complete whatever procedures need to be done. She doesn't want to have to commute back and forth to Manhattan but my sibling and I offered to set her up in a hotel and we'd take turns staying with her.

Her regular/general dentist is not equipped to deal with the tooth decay given her history with oral cancer, not that I'd want her going to him anyway. I know she can't have certain teeth extracted because of radiation treatment. I think extraction leads her vulnerable to disease of the jawbone due to radiation.

We haven't learned what procedures will be needed yet as she is consulting with a local dentist. I'm just wondering if anyone has experienced a similar situation.

Thanks for listening,

Maura

I had to have teeth extracted (all of them), and they had me do hyperbaric oxygen treatments prior to the surgery. That may or may not be an option available to your mother. It's protocol for us radiation patients, from what I gather. An oral surgeon did the extraction, though, not my dentist ... outside her abilities, and she knows it. I'm on the working-on-dentures stage now. So ... it's something to ask about.

ETA: This was recent; my radiation was some years ago.

Any dentist who your mother sees that is not experienced in treating oral cancer patients should not be an option for your mother. Unfortunately, most dentists are NOT equipped to properly care for someone who has had OC. Any OC patient who went thru radiation treatments MUST for the rest of their lives pay careful attention to their dental needs. That means brushing and flossing after every meal plus in the morning and at night before bed. They should also continue using their flouride trays.... every single day! Teeth take a very hard hit from patients who have rads. I ended up losing ALL my teeth from radiation damage and that was using the flouride trays daily. A water pik used on its lowest setting with warm water and non-alcohol mouth rinse or prescription peridex is another great tool to help make certain your mom is getting in between her teeth to keep them as clean as possible. Many OC survivors will see a prostheodontist instead of a regular dentist.

If your mothers teeth are bad enough that she needs extractions, make sure she is seeing someone who sends her to hyperbaric oxygen treatments (HBO). The Marx protocol is 20 dives prior to and 10 dives after any extraction. This should help to prevent further problems with osteoradionecrosis (ORN) which brings a whole set of other problems if she ends up with that.

Best wishes with your mothers current teeth issues. Prior to selecting which dental professional to go with, a second opinion would be a wise move. Good luck!!!