Leah, I have Kaiser also they they gave me a choice of Stanford or UCSF (both comprehensive cancer centers) because their contract radiation oncology centers (Kaiser doesn't do irradiation in-house) were not offering IMRT at the time. I know that the Mt. Diablo one was in the process of updating their LINAC to accomodate an IMRT MLC, so that may have changed. I had my chemo at Kaiser and my follow-ups are with a H&N surgeon from Kaiser and I have been very impressed with the standard of care there. They always followed the NCCN oncology practice guidelines. Kaiser allows you to "shop" for doctors on their website. I chose a H&N surgeon that I have confidence in. He went to medical school at UCSF and did 8 years at Childrens Hospital in Oakland.

Most scans are merely a component of the entire diagnostic package and are rarely the complete basis for treatment decisions. Many time you will dicsover the RO and Oncologist relying heavily on scans and the H&N surgeon almost ignoring them. They are always subject to interpretation and often the radiologists are very conservative in their readings. They are duty bound to annotate ANY anomaly and let the H&N surgeon and other team members sort it out.

Radiation itself typically won't "kill" a tooth unless the total fractional dose (through that specific area) exceeds (I believe 62 cGy) which is unlikely the way that radiation treatment is programmed. What CAN happen is if the teeth are in bad shape or there was gum disease prior to treatment these conditions will be exacerbated by the radiation damage to the gums but mainly the issue is damage to the salivary glands which protect the teeth from decay. Impeccable dental hygiene is an absolute must from now through the rest or your life. Radiation damage to the capillaries in the mandible and jawbone don't allow for the bodies adequate response to bacteria and infection from a diseased tooth (there is inadequate blood supply to bring antibodies to fight infection) and OsteoRadioNecrosis may result (ORN).

I personally only had CT scans for radiation therapy planning purposes. MRI scans are the standard for annual followups (according to my CCC) and a baseline one should be taken pre-treatment. New data, recently published has suggested that x-ray radiation should be avoided if possible. MRI's are very safe and also superior for examining soft tissue.