Hello again,

Well, my treatment date is already in sight even if it hasn't been set. The radiation oncologist said she would like to start two weeks after a particular tooth was pulled. That happened this Monday. Next Monday I go in for my radiation prep (set up the mask, positioning?) and presumably am on track for beginning my 7 weeks of treatment the Monday after that. (Woo hoo!?)

So about the tooth thing then. The radiation oncologist and my every day dentist went over my existing xrays and I was sent to an endontologist for a new 'cone' xray. Everyone agreed that of the two teeth (#3 and #4) under suspicion that #4 was fine and that #3 should go. I had the molar extracted (:shudder: awful, even though numbed) and am ready to move on. My dentist would like to continue to address the now missing molar (prep for a future bridge, etc.) but understands that this isn't where the priority is for the oncologists and I supposed I can always have the 'gap' dealt with in the months following treatment. If it needs to be said (it is in the subject), the goal here in pulling the tooth is to reduce the risk later of radiation caused 'osteo-necrosis' or bone death in the jaw bones.

So my questions really are; how common is this for those of you with head-and-neck cancer who have had IMRT (and Cisplatin; but I guess it's really the rads)? I concede that my teeth are actually pretty bad; lots of cavities, fillings, crowns and some root canals in my 47 years so far. I'm doing a lot better in the past 3 years taking care of them but this one, #3, was a root-canaled molar from days gone by and when it came out they did find infection underneath it all (indicated on the cone xray as well as a somewhat faulty root canal to begin with however many years back it was).

And what are the repercussions with waiting on getting work done (bridge) for a few months until well after treatment and I'm up to it?

Also - I have seen many people (whether they got teeth pulled or not) talk about 'trays' for flouride treatment of their teeth. This is due to the lack of saliva and difficulty brushing/cleaning? Nobody has talked to me about trays yet.

Thanks in advance - you guys really are an invaluable asset.

Paul

Dx at age 47 (in 2014-06), non-smoker.

2014-06 biopsy confirms SCC in BoT w/ HPV16+, Stage T4aN2M0
main tumor plus 2 nearby lymph nodes; bilateral; no metastasis?

2014-07-01 single molar (#3) extracted

2014-07-21 IMRT (35x) and Cisplatin (3x) have begun

2014-09-05 IMRT and Cisplatin finished! (only had 2x Cisplatin - weeks 1 and 4)

2014-09 to 2014-12 Recovery. I think I can...

2014-12 follow-up PET/CT scan is negative. All clear!

2016-05 all subsequent PET/CTs negative.