I am new to this site,but glad Ifound it.I have had radical neck surgery on dec.7,11 and am in my fifth week of a six week radiation treatment program. So I am concerned ,after reading many posts about posters loosing all there teeth. Does this happen to everyone that goes through radiation?

Stephenf - My son did not lose any teeth due to radiation, but it probably depends on the type of cancer and where exactly the radiation is directed. Perhaps you could tell us a little more about your own experience and type of oral cancer? My son had SCC (Squamous Cell Cancer) just under the right side of his tongue and had 1/6 of his tongue removed. I'm sure others will be along that can relate more directly to your own experience. It's good you found us here. It's the best place to be for the very latest information and compassionate help. Let us know how you are doing.

Welcome to OCF Stephen. There are over 8000 members of OCF. Recently there has been a thread about losing teeth from radiation damage. I would guess that there could be at most 20-40 members who have been affected by this. That figure is actually very low out of 8000! My teeth werent the best going into rads so it wasnt a huge surprise to me. I had fully expected to get implants or dentures unfortunately I had a Stage IV recurrence with complications making future teeth next to impossible.

It is imperative that an oral cancer patient who goes thru radiation use flouride trays for life and take impeccable care of their teeth. Brush after every single meal, use a waterpik with some peridex (prescription mouthwash) watered down twice a day and use the trays nightly. This will become a routine for you.

Best wishes with your treatments and recovery!

Stephen

Short answer: NO
Longer more verbose answer: The majority of people do NOT lose their teeth from radiation TX. As Christine notes, the deciding factor is the condition your teeth were in before radiation. Often patients have their teeth taken out before the radiation to avoid problems that are foreseeable.
My doctors insisted I see a specific prosthodontist (a dentist with advanced degrees) who specialized in oral cancer patients for a complete evaluation before TX. He cleared me for TX but noted I would need work afterwards. Basically once you have radiation, it's problematic to have any teeth pulled since the jaw may not heal. Getting cavities filled, crowns put on, or even root canals are all okay (I've had all of that done after my first bout of radiation with zero problems).
I do use my flouride trays every day even though I don't eat since the mucous actually supports plaque & decay.
Get recommendations from your treatment team on a dentist or prosthodontist as cancer doctors usually know good ones with cancer experience.
Charm

My teeth are a mess, but I go every 3 months for cleaning and flouride treatments, as well as using the trays at night. I seem to have a lot of cavities, but neither my RO or my dentist feels the need to pull them. I had a thorough dental exam and x-rays prior to radiation.

My husband had his teeth checked prior to treatment but the dentist was not familiar with oral cancer. He has lost most of them gradually to decay and loosening but their is a difference in loss between the side where he received the heaviest radiation and the other side of his mouth. He has had bone growth material and is getting 16 implants in the next month or two.

I haven't lost mine, but my dentist (an oral cancer survivor himself) has worked hard to keep it that way. You just have to be vigilant and maybe see the dentist a little more often than you used to.

Thanks for all the responses,I did goto my dentist before I started Radiation.He did a lot of preventative maint. Work ,I have fluoride trays,electric toothbrush and flosser and he made it clear to me how important dental hygiene would be. so I have been working on that,

I wish I could have kept mine but the Drs say I would have lost them, not from just the radiation but add in the Implants and Chemo and POW, they would have gone then. If only I had to or enough to gnaw a stek bone or some nice Porterhouse tail fat.

Oncologist said I would loose my teeth

Radiation OC said, maybe

My dentist, bless her heart, said she didn't see any reason to pull them, so let try to get through this intact. She won

Made it through with the teeth and have had no problems to date.

Kevin

My husband Ron is starting to have more dental "issues" as time goes by. I guess that's why they call radiation the gift that keeps on giving. But he didn't have the best teeth to begin with. Hope you'll be OK!

All the best,

Shelley

Stephen, it sounds to me as though you've taken all the right precautions. As I'm sure your docs have told you, radiation can affect your parotid (salivary) glands rather negatively. Every one of us has a different reaction so you'll need to see how much xerostomia (dry mouth) you end up with. Which probably seems like crazy talk right now to you, as no doubt you're experiencing all kinds of excess mucous from the RT.

But that will go away in time (even though it can be hard to believe sometimes). There are a number of products that can help with the dryness and I hope you've been given prescriptions for appropriate fluids and balms, etc.

Many of the post-treatment products are made by Biotene, which is the brand of toothpaste and mouthwash recommended to me and that I use every day in addition to the fluoride trays. They also make gels and gum and whatnot.

As you progress through treatment and recovery please ask your team about this, as well as all of us here.

You're meeting this challenge with great spirit and courage!

Thinking of you.

One thing I was never aware of is that older people often have a saliva reduction, some more severely. So then their teeth tend to decay and they lose them. They don't need radiation to make this happen, it happens to them as part of their particular aging process, which may be exacerbated by various drugs they are on. That is not to say older people all have dentures, no, no, no. But there are some older people that struggle just the way we do with lack of saliva. I myself don't have tons of saliva at 12 months out, but my mouth is certainly moist, and I can eat some foods that others can't (bread, pita chips, for instance) so I guess I am doing ok. My husband, a GP dentist, tells me that I have lots more saliva than several of his older patients, who brush, floss, and fluoride their remaining teeth, as it is a battle for them.

It is, as David pointed out, the dry mouth (xerostomia) that creates much of the problem. Then of course, the saliva that we have left may not have the same protective properties our "old" saliva possessed. Now of course, I am not going to decide just what defines those "older people" in terms of numerical age. I was younger, now I'm getting on the far side of middle aged, I guess.

Best,
Anne

I cannot stress it strong enough to get yourself to floss every night. You only need to do it once before bed as it takes 24 hours for the plaque to build up.

My dentist said if everyone flossed he'd be either out of a job or working part time.

Just stay on top of it. Use the trays after you floss and brush. You may lose a couple but fight very hard to keep them all.

And BTW, your dentist needs to be familiar with radiation and teeth. The cavities grow on the bottom gum line and a lot of dentists don't want to try to fill them there as it's hard to do. Make a pact with your dentist that together you won't lose any.

Good luck,

Tom

I have not read anything about Hyperbaric Chamber treatments on this question.
Treatments are called "Dives", as you are in a pressure chamber, with pure oxygen for 1 to 3 hours at a time, to a pressure equivalent to 35 to 40 feet underwater.
This forces O2 into your cells, and is quite remarkable in resulting healing rates.

I was warned before my jaw/tongue replacement, that I could suffer from "bone death" if I had subsequent jawbone exposure( teeth removal), WITHOUT FIRST going thru HBO2 treatments.
My teeth were bad from oral radiation 2 years previous to jaw transplant, dry mouth, resulting in advanced decay of teeth.
My surgery resulted in 2+ weeks in forced coma, while the hospital fought donor-site infection: imagine what damage that can do to your teeth, plus 2 weeks intensive care/recovery, not a toothbrush for nearly 4 weeks straight.
My dentist got with my oral surgeon before surgery, they planned my teeth treatments, so they and I knew what to expect.
After surgery, DDS rebuilt my teeth, did not pull any.
Hyperbaric Treatment is extremely important, see if it is available in your city, as many treatments are required, I was scheduled for 40.
Knowledge is Power

my dentist just gave me the estimate to save my teeth-40k before he does the bridge he isn't sure will hold. my wonderful health insuranc will pay to have my teeth extracted if it is seven or more. my doc says everything i do with my teeth is at risk of infection. my dental insurance will now pay for 4 peridontal cleanings a year, which i think i should skip if i need to lose my teeth. insurance is the pits. any suggestions?

i hate life

Find another dentist and tell this one you're unwilling to completely fund his new Mercedes... You can get a full set of the best veneers for 15,000 he's just greedy

Mick,

As hard as it is for me to say this...I agree with Cheryl (wow, less painful then I thought it would be!! ) find a new dentist.

Facts of the matter are that our teeth after treatment need good care and even then they will break down at a rate faster then "normal". Not only do they breakdown due to the radiation but the xerostomia (dry mouth) usually experienced by Oral Cancer patients. Due to facial paralysis one side of my mouth droops and never closes, furthering the dry mouth and making my teeth deteriorate even faster. I've come to grips that I'll have to have them all pulled and have implants as dentures are out of the question on my lower due to the mandiblectomy.

Where it's a pain in my ass, it's not the end of the world to me. I've learned to live on mostly a liquid and soft food diet, even gain significant muscle mass. I know life is much more then a set of pearly whites. When I'm finally able to have the rest of my teeth extracted and implants put in then great, but I won't allow the little details take away from the fact that I'm alive and can make the most out of each day.

Keep your chin up Mick, it's a journey my friend.

Eric

Find a dentist who specializes in Prosthodontics. They will be familiar with how to best take care of your teeth. Dont give up and lose them because of your dentist. Its not his teeth. Hope you will fight to keep them. Take it from someone who lost theirs, teeth are necessary to having a more normal life.