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#196350 - 05/06/18 02:58 AM dealing with osteoradionecrosis and dental infecti  
Joined: Feb 2003
Posts: 3
barbee Offline
barbee  Offline

Joined: Feb 2003
Posts: 3
Potomac Maryland
i am 18 year survivor stage 3/4 tonsil cancer now dealing with osteoradionecrosis in left mandible with infection in lower jaw back molar as well. had. charity dental treatment for several years but no longer. No dental insurance but medicare and supplement F in place. Was on Medicaid before 65 and no oral surgeons accepted it in my area. Hoping Medicare will be more helpful.

i am just starting to have recurring difficult to treat dental infections again. have had three in past 18 years requiring 20/10 hyperbaric treatments for each extraction. just finished third extraction a few months ago after 3 months of antibiotics prior to hyperbaric 20 dives followed by 10 more after extraction. Now the left back molar area hurts and my face is swollen...likely a dental infection as well as osteoradionecrosis already diagnosed in my mandible there.

Last edited by ChristineB; 05/06/18 12:19 PM. Reason: combined similar posts
#196354 - 05/06/18 12:25 PM Re: dealing with osteoradionecrosis and dental infecti [Re: barbee]  
Joined: Jun 2007
Posts: 10,148
ChristineB Offline
Administrator, Director of Patient Support Services
ChristineB  Offline
Administrator, Director of Patient Support Services
Patient Advocate (old timer, 2000 posts)

Joined: Jun 2007
Posts: 10,148
Im sorry to hear what you are going thru. As for insurance... this could be considered medical due to it being related to the osteoradionecrosis. It all boils down to how things are coded in the office. If something is billed to medical insurance and it is denied you may need to appeal it and speak to the offcie manager as to exactly what codes were used and if that is correct.

Do NOT fool around with dental infections. They can quickly become a very serious health problem. Any swelling of the head/face/neck areas needs to be addressed before it gets worse, it could affect your breathing. A family doc can prescribe antibiotics. If necessary, go to the ER and get strong antibiotics started right away.

Good luck!!!

PS... Im sending you a private message (PM) with a link to help you with posting. click on the tiny flashing envelope.

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
2 mo xtended hospital stay, ICU & burn unit
PICC line IV antibx 8 mo
10/4/10, 2/14/11 reconst surg
OC 3x in 3 years
very happy to be alive smile
#196360 - 05/07/18 06:35 PM Re: dealing with osteoradionecrosis and dental infecti [Re: barbee]  
Joined: Jul 2012
Posts: 3,117
PaulB Offline
Patient Advocate (old timer, 2000 posts)
PaulB  Offline
Patient Advocate (old timer, 2000 posts)

Joined: Jul 2012
Posts: 3,117
Hi Barbee,

I have a similar story as far as ORN goes. I needed all my teeth extracted due to treatment, but it was not covered by Medicare. The oral surgeon in the cancer center did it for charity, but I was charged by the anesthesiologist, who I worked out a payment plan, but somewhere along the line, probably when I changed hospitals, i stopped making payments, and just remembered it as I write. I think they write it up as a loss. As a result from surgery, I developed ORN, and need further surgery, sequestromy, to heal the wound, which didn't work either.

I asked for more HBOT, and Pentofoxilline/Vitamin E, but the surgeon said it was already late stage ORN, there are three stages at one society, four another, so I had a mandibulectomy, which I needed additional surgery for the leg wound.

As far as medicare goes, you may have to appeal any denials. I was also reading into teeth extractions surgically, which may be covered if it’s done by other than a dentist, but at this point of time, four years, I forget all the particulars. There is a medicare ruling on this, if you want to look it up or may have posted here in 2014.

I hope this helps.

10/09 T1N2bM0 Tonsil
11/09 Taxotere Cisplation 5-FU 6 Months Hosp
01/11 35 IMRT 70Gy 7 Weeks
06/11 30 HBO
08/11 RND PNI
08/12 RND Pec Flap IORT 12 Gy
10/12 25 IMRT 50Gy 6 weeks Taxotere Erbitux
10/13 SND
10/13 TBO/Angiograph
10/13 RND Carotid Removed IORT 10Gy PNI
12/13 25 Proton Therapy 50Gy 6 weeks Carboplatin
11/14 All Teeth Extract 30 HBO
03/15 Sequestromy Buccal Flap ORN
09/16 Mandibulectomy Fibular Flap Sternotomy
04/17 Regraft hypergranulation Donor Site
06/17 Heart Attack Stent

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