If I had listened to the dental oncologist at UCSF they would have pulled ALL of my teeth! I just go to my regular dentist and educated him on my needs, which are actually pretty simple. NO extractions or I will have to do HBO therapy prior. I increased my cleaning schedule to 4 times a year and he makes repairs sooner rather than later. I had to educate them about ORN.
They are very careful. His son just graduated from UCLA school of dentisty and they had a section of the course that dealt with oncology patients.
I am almost 3 years post Tx now and my teeth are doing fine. I still use my dental trays with flouride occasionally and practice scrupulous at home dental care.

I asked my chemo oncologist today for information on a dentist in my locale that might have experience in dealing with head and neck cancer patients. Hopefully, they will get back to me.

Thanks for the heads up Gary. About an hour ago my previous dental office finally called back. I scheduled a cleaning (which I believe they can handle) but should I need to get anything further done, I might decide to get another dentist.

The receptionist once again told me that they do handle cancer patients, but handling someone that is technically a cancer patient doesn't always mean they are aware of the special circumstances of someone who has had radiation to the head and neck area.

Just as a general guideline, the main thing I have to be on high alert for is if they do an extraction right? Otherwise normal fillings should be okay?

Thanks, Jen

Hi Jen, extractions are to be avoided at all costs. Filings, crowns, etc. are perfectly ok. Make sure to ask the hygenist if they clean below the gum line - much to my susprise I learned that some don't. I take it you have dental trays and are doing flouride at home? Have them give you a flouride treatment everytime you go in (they use much stronger stuff - bring your trays with you).

The only special circumstance is that we have a 10% risk of ORN if we have to have an extraction. Make sure that they know it is imperative that your teeth be perfectly maintained as possible. Any good dentist should be able to accomplish that. I had full mouth x-rays done a year after treatment to insure that nothing was rotting out where I couldn't see it.

Also use the floss that has the candy cane image on it. It's a lot like yarn and very easy on the gums.

Hi Jan,
I had my surgery done at the Mayo Hosiptal in Scottsdale, Arizona. The Mayo System has just hired special dentists who work very carefull with the head surgeon and are making great progress with persons who have had radiation etc. check them out. I know you won't be sorry.

HI,
I had SSC 7 years ago, tongue resection, neck nodes removed(2nd layer positive) and 42 radiation treatments. Mouth care is essential. I go routinely every 2 months and have many fillings at the gumline and many caps because my teeth are deteriorating. My dentist who has been very good has finally said I need a specialist because my gums are turning into mush. My rad MD suggested a prostodontist at Sloan in NYC. My insurance is giving me a hard time since he is not on my plan?? I called 2 oral surgeons that Cigna recommended and they dont have a clue about post radiation effects. I have been able to keep my teeth so far with water pik, sonic care tooth brush and flouride. If some of you are very sensitive brushing , I found brushing in the shower was the best.(shower saliva) and definately get a water pik! If anyone knows a dental oncologist in NJ let me know. I have an appt with Dr.H at MSKCC in 2 weeks for a consult. (Hopefully insurance will cover)Maria

Got a ?. What is ORN? HBO is hyberbaric right?
Thanks, Mary

Mary,

I think ORN is OsteoRadioNecrosis which basically means bone rot due to prior radiation--it can happen when the jaw bone gets cut into or exposed to the air during dental surgery and its a nasty nasty thing to get according to my oral surgeon. The risk of it also is there, once you have had head and neck rad, for the rest of your life. It does not decrease over time.

Nelie

Hi Mary,

Nelie is right on with the definition of Osteoradionecrosis. Basically bone that has received doses of radiation may lack the ability to repair itself after trauma. Radiation destroys the blood vessels in the area causing a reduction of circulation to the area of oxygen and other nutrients. This then will prevent normal healing in that area if the bone is injured.

Hyperbaric oxygen to the area will stimulate new blood vessel growth and therefore stimulate bone healing.

Hope this has been helpful.

Jerry

HI
I had a question about dentistry and oral cancer. Somewhere on this board I had read about a special light that some dentists can use for their exams on paitients of high oral cancer risk. From what I recall the light is able to pick up on abnormal type cells in the oral cavity. What type of equipment is this and how do you find a dentist that uses it?

Thanks
Tami

Tami,

I don't have any personal experience with it, but if you search this site using the word vizilite, you'll find quite a few posts about it.

Cathy