Hello Forum;

I am currently faced with a difficult dilemma regarding the future of my teeth, and hope to gather as many different points of view as I can before making an informed decision.

The current condition of my oral cavity is summarized as follows: I have taken good care of my teeth all my life, and managed to retail them throughout cancer treatment except for one extraction and a few fillings that were completed prior to the commencement of treatment 3 years ago.

Treatment left me with severe trismus and little or no saliva flow, as well as some exposed bone on my lower mandible due to osteoradionecrosis. I had 40 dives in the hyperbaric chamber 1 and 1/2 years ago in preparation for surgery to remove the dead bone, but the resultant wound failed to heal and the bone remains exposed. My oncology dentist has been monitoring the wound site, and so long as it didn't cause me any pain or discomfort, we would simply leave it alone.

During my last regular examination, they took a panoramic full mouth xray, and discovered some more dental caries as well as an impacted wisdom tooth and rather than trying to restore those teeth, she recommended most of my upper and lower teeth be removed as a matter of convenience.

I still rely 100% on a stomach tube for all nutrition (except for the mandatory cup of coffee in the morning!), and it will likely remain that way for the balance of my time on the planet. In other words, I probably won't need my teeth for eating any time soon.

I met with the oral surgeon, and he is concerned about getting access to the exposed bone, and concurs with the oncology dentist that all my teeth be removed except for those in front (upper and lower)in one fell swoop under general anaesthesia in the hospital.

On the brighter side, I am not experiencing any pain or discomfort associated with the exposed bone, and would prefer to hold off on the surgical removal for as long as possible.

I have been scheduled for another 40 dives in the hyperbaric chamber in early August, and they would like me to have the surgery done after 30 or so dives, with the balance of 10 dives immediately thereafter.

I don't expect my oral health will improve at all on its own, and sooner or later I will have to face the oral surgeon. The radical neck dissection I had left me somewhat disfigured, and I am hoping to put off any further disfigurement to my appearance as long as I possibly can.

Should I just bite the bullet and get these surgical procedures behind me as scheduled, or should I hold off as long as I can or until any pain or discomfort arises?

For those of you who have experienced a similiar situation, I would greatly appreciate hearing your stories and what you would do differently if you possibly could.

Please don't worry about being sensitive or telling me like it is - after what we've been through thus far, there's little that can hurt me now.

Thanks in advance for your replies!

Sincerely,
JT2