My husband has been told that he needs a root canal on a tooth that was in the field of his IMRT radiation. The timing of this really stinks because he just completed his rads tx a week ago Wednesday.

I have read a bit about the need for HBO surgery if extractions are required but need to know if this also applies to root canals?

I am very nervous about this since I am afraid on any long term reprecussions if this is not addressed correctly.

I did a search through the archives and perhaps I am not searching correctly because I could not find an answer to this specific problem.

Can anyone offer any insight on this?

Thank you!

Try searching on root canal. I think Brian just said HBO is not required for root canals and my MD Anderson trained prosthodontist agrees.

Take care,
Eileen

Generally endodonic treatment (root canals) are not an issue to people who have had radiation. What you want to be careful of is getting the infection that accompanies them under control.

Thanks to Brian and Eileen for their replies. Gordon is seeing a dentist on Thursday to have a biopsy to see whether the tooth needs to be extracted or whether a root canal will suffice.

That I guess will determine how we proceed next.

My next question is do most people after having HN rads tx go to a oncology dentist?

Norma, since I live about 50 miles away from my CCC, I see a regular dentist locally that was kind enough to get me in before treatment to clean and xray my teeth. I was completely forthcoming at the initial visit and told him that I would be getting radiation and chemo.

Granted I haven't needed any heavy work done since treatment ended, but at least I was reasonably reassured by my local dentist that he understood my special concerns.

As a backup plan, I asked and will continue to ask my radiation oncology department for referrals to dental professionals should I need anything special just to have those names on hand. I was amazed that they actually did have some names on hand for dentists in the area.

Jen

Well, we saw the RO today when Gordon went in for hydration (he is still having difficulty getting fluids into his system.) He took another look at Gordon's tooth and informed us that there is an a questionable area that is either an infection or possibly a tumor. The dentist tomorrow will either drain the infection and inspect the tooth or take a biopsy.

As I wait until tomorrow's appointment, I cannot help but wonder why this area, if it is a malignant tumor, would not show up on the PET scan or CT scan he just had in the past 2 weeks? I didn't think of it at the time to ask the rads onc when we were with him because my head felt like it was going to explode.

He did say that contrary to my belief, that area of his teeth was not in the rads field so that is why if it is a tumor, it was not resolved by the rx tx.

Just when you think it is time to start to breathe easier something else like this comes along and just kicks you in the stomach with renewed fear.

We'll keep our finges and toes crossed for youall, Norma. Amy

When you say that the area feels like it is under pressure, that is a good indicator of infection and abscess. Also the lack of high suv values on the PET in the area is encouraging. If this is what it turns out to be, I would highly recommend a root canal and draining combined with appropriate antibiotic treatment as a first course of action. Keep the idea of an extraction in reserve until it has to be done. That will mean 02 dives prior to extraction and the danger of a non-healing wound after the extraction is done. On a common radiograph/panorex the dark area of an abscess at the tip of a root is pretty easy to distinguish. Bone tumors will be more diffused in size and sometimes have what they commonly refer to as soap bubble radiolucency, which looks very different from a very circumscribed dark area at a root tip for an abscess.

Hi Norma,
My cancer was found when I had a back tooth removed. The dentist bugged at me during a cleaning to let him take it out as it was loose and showed signs of periodontal disease. I gave in, but said no the first three times he asked me because the tooth didn't hurt. I did't chew on that side of my mouth but that was because the tooth was loose and, if pushed, I might admit to it being tiny bit sore. But, there was certainly NO pain. Even after the tooth was removed, and the area didn't heal well, there was NO pain. I'm hoping that your husbands pain means it will NOT be cancer.

Hi Norma,

As usual, Brian has come through with excellent dental advice. I am anxious to hear how Gordon made out today with his dental appointment.

Jerry