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This question is specifically about post radiation patients.

Is there a recommended frequency for dental scaling after radiation. I ask because I started out with one doctor who told me to never get my teeth scaled. And now I see a doctor who says I need it four times a year because I'm post radiation and cannot risk periodontal problems. But the fact is, every time I get a cleaning from him, I risk infection, which is also problematic for post-radiation people.

I worry that I've gone from one extreme to another. Are there any guidelines about this? Was your frequency changed post radiation?


Squamous cell carcinoma base of tongue. Lymph involvement unclear; staging placed at "2 or 3." Biopsy 4/18/2008. Treatment: IMRT every day for 7 weeks. Cisplaten once a week to sensitize cancer to radiation. Treatment ended 7/16/08. PET/CT shows no more cancer.
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Andrew, not familiar with the term scaling, but I was advised to get a teeth cleaning 3x/year. I've done this for the 6 years post rads and, knock on wood (my teeth, maybe?) I've been fine. Look forward to reading what others have to say.


David 2
SCC of occult origin 1/09 (age 55)| Stage III TXN1M0 | HPV 16+, non-smoker, moderate drinker | Modified radical neck dissection 3/09 | 31 days IMRT finished 6/09 | Hit 14 years all clear in 6/23 | Radiation Fibrosis Syndrome kicked in a few years after treatment and has been progressing since | Prostate cancer diagnosis 10/18
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Andrew, I'm not familiar with the term scaling either. I googled it, and it sounds like teeth cleaning. Am I missing something?

Since my treatment ended, I go for a dental check-up and cleaning every 3-4 months. The cleaning is done by a registered dental hygienist (RDH).


Susan

SCC R-Lateral tongue, T1N0M0
Age 47 at Dx, non-smoker, casual drinker, HPV-
Surgery: June 2005
RT: Feb-Apr 2006
HBOT: 45 in 2008; 30 in 2013; 30 in 2022 -> Total 105!
Recurrence/Surgeries: Jan & Apr 2010
Biopsy 2/2011: Moderate dysplasia
Surgery 4/2011: Mild dysplasia
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I think scaling is more of a deeper cleaning, down below the gum line. Please correct me if this is wrong.


Christine
SCC 6/15/07 L chk & by L molar both Stag I, age44
2x cispltn-35 IMRT end 9/27/07
-65 lbs in 2 mo, no caregvr
Clear PET 1/08
4/4/08 recur L chk Stag I
surg 4/16/08 clr marg
215 HBO dives
3/09 teeth out, trismus
7/2/09 recur, Stg IV
8/24/09 trach, ND, mandiblctmy
3wks medicly inducd coma
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Yes, I was talking about a periodontal cleaning that goes deep below the gum line.

But now that you pointed out the difference, it would be interesting to hear what sort of cleaning people are getting and how often.

1. Periodontal goes very deep below the gum line. Also called scaling and root planing.

2. Normal dental goes below the gum line but not deep.

3. Extra conservative avoids even touching the gum.

4. Maybe something else I have not listed.

What kind of cleaning do you get, and how often. Have you had any problems.

In my case, I was first told that the dentist must stay one millimeter above the gum line, never even touching the gum. Now I'm at the other extreme getting periodontal cleaning. I was also told to never allow a technician to use an ultrasonic cleaner.


Last edited by Andrew111; 10-03-2015 11:04 PM.

Squamous cell carcinoma base of tongue. Lymph involvement unclear; staging placed at "2 or 3." Biopsy 4/18/2008. Treatment: IMRT every day for 7 weeks. Cisplaten once a week to sensitize cancer to radiation. Treatment ended 7/16/08. PET/CT shows no more cancer.
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I found this helpful understanding the scaling and root planing.

https://en.m.wikipedia.org/wiki/Scaling_and_root_planing


10/09 T1N2bM0 Tonsil
11/09 Taxo Cisp 5-FU, 6 Months Hosp
01/11 35 IMRT 70Gy 7 Wks
06/11 30 HBO
08/11 RND PNI
06/12 SND PNI LVI
08/12 RND Pec Flap IORT 12 Gy
10/12 25 IMRT 50Gy 6 Wks Taxo Erbitux
10/13 SND
10/13 TBO/Angiograph
10/13 RND Carotid Remove IORT 10Gy PNI
12/13 25 Protons 50Gy 6 Wks Carbo
11/14 All Teeth Extract 30 HBO
03/15 Sequestromy Buccal Flap ORN
09/16 Mandibulectomy Fib Flap Sternotomy
04/17 Regraft hypergranulation Donor Site
06/17 Heart Attack Stent
02/19 Finally Cancer Free Took 10 yrs






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I get regular cleanings every 3-4 months by a Dental hygienists, my dentist then gives me the full exam after every cleaning!! Semper-Fi Bob


Bob age 57, non smoker,non drinker, ended treatment on 11 Nov 2007 and started back to work on 29 Nov 2007. Veterans Day 2012 the Battle was lowered, folded, Taps was played and the Flag buried as I am know a 5 year survivor. Semper-FI !!!
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Paul, thanks for that link. A very informative article about procedures that I hope never to need!


David 2
SCC of occult origin 1/09 (age 55)| Stage III TXN1M0 | HPV 16+, non-smoker, moderate drinker | Modified radical neck dissection 3/09 | 31 days IMRT finished 6/09 | Hit 14 years all clear in 6/23 | Radiation Fibrosis Syndrome kicked in a few years after treatment and has been progressing since | Prostate cancer diagnosis 10/18
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It looks to me like nobody (at least who replied) is getting periodontal scaling. You are getting dental cleaning 2-4 times a year.

Where there any special instructions given regarding the cleanings?


Squamous cell carcinoma base of tongue. Lymph involvement unclear; staging placed at "2 or 3." Biopsy 4/18/2008. Treatment: IMRT every day for 7 weeks. Cisplaten once a week to sensitize cancer to radiation. Treatment ended 7/16/08. PET/CT shows no more cancer.
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I get them scaled every 3 months. My Dentist consulted my RO and no issues were raised by her. I trust her completely. My dentist group is your generic family group, but they consult my RO before each major issue (root canals ect.)

I think it depends on the nature of the cancer, my tumor was very small but spanned the area between base of tongue and my tonsil.

I am 40 years young and just had a scope yesterday by the ENT that told me it couldn't look better. Almost 2 years from diagnosis right now.



Brian
Stage IV TxN2aM0 HPV+ SCC 38 y.o. male
9/20/13 Sentinel Node Found
12/5/13 Start of 72Gy and 5 bags of Cisplatin
1/21/14 Treatment Ends
1/25/15 1 Yr clear

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