Dear Jerry,

Thanks so much for your prompt and insightful response. I have needed to hear from someone knowledgeable. Yes, it is unsettling to know that I lived with the cancer in my mouth much longer than necessary, and even that it was disturbed by cauterization not once, but twice, and was still not recognized or suspected. This is, legally, "failure to diagnose," but I have decided not to pursue anything legally, choosing instead to focus on positives instead of expending that sort of energy on such a negative activity as a lawsuit.

I guess I will go with the metal obturator. I am a teacher and a singer, and, while people say that I sound fine, I am often asked to repeat things, so I know that I am not being understood as well as I would like to be.

I also have a nasality to my speech that I plan to work on with a speech therapist, after I get my more definitive obturator.

I really don't know what to do about the implants. What you say makes a great deal of sense. First, I have been tempted to have my prosthodontist make another, more definitive device using the wire clamp, just so that I didn't have to have another procedure. I realized just this week that I think that I have been more in denial than I had thought....that if I do something as permanent as the crowns or implants, it means that this is a permanant condition, and I have been avoiding that reality. This IS permanent, and I guess I have to do whatever I have to do to make the best of it.

The first choice for implants would be a pterygoid implant, but I no longer have that bone available. The only other choice is a zygomatic implant..actually two, for stability...I have consulted the guru, Dr. Stephen Perel, at Baylor Dental School in Dallas, and that is what he recommended, but then, it is his field of research and expertise. My own prosthodontist did not even mention the zygomatic implant, but when I asked him about it, he said it might be something to consider.

This is another issue that has been driving me crazy: Why didn't he mention it at first? Why did I have to discover it on my own??? I don't have the confidence that I need to get through this process, either from him or from my surgeon, who has been a little casual about some things, in my opinion, and, of course, from my dentist.

I guess I need to post another query about the implants specifically. I don't want to get into a circumstance where I will have bone pain from such an implant.

You and I are close to the same timing. You are a little ahead of me. Will you have more procedures, or are you finished? Did you have any radiation?

I am a little concerned about not having radiation, since my lesion had been there for so long, but my surgeon says that he was "aggressive" enough to consider that I am cured. I sure do hope he is right!!

Thanks for your help!

--August