All,

I am finding it helps to focus on next steps to get through the emotional lows and would like some advice and thoughts on dental issues. I have read through the archives and am not sure I still have the answers or all the insight from this group.

A quick update on my status: 3x Chemo is done - 2 more radiation treatments. No teeth extracted pre-Tx. Fitted for trays, but have not received yet (might have been a miss by the medical team, not sure but following up).

Questions:

1. Appears dental issues are virtually imminent. Besides keeping great dental care/hygiene, are there any proactive steps that can be taken before deterioration of teeth/bones? This would include implants or dentures prior to needing them if it is easier to do while things are in better shape?
2. I read where people are having teeth pulled but not a lot about replacement. Are there issues with dentures or implants in oral cancer patients where they cannot wear them?

Basically - cosmetically and functionally I want to have teeth and would like any insight on what to expect and proactive things I can do.

Thanks in advance for your help.

Jasper

Please follow up and get those trays ASAP. Its very important to be using the flouride trays every single day.

Radiation does a number on teeth and the flouride will help to protect them. You do NOT want to lose any teeth as you would need to go thru quite alot for what formerly would have been a very simple procedure. It may require tubes put in your ears and about 2 months of HBO which will tie up 3 hours of your day every day.

I lost my teeth due to radiation damage. The teeth became very loose and crooked. It felt like they would just fall right out. I could barely eat due to them shifting whenever I tried to take a bite or chew anything. My plan was to get dentures about 6 months down the road but instead I got OC again. The surgery on the third round of my OC was drastic and removed my lower jaw. Plus I had major complications with heeling on the upper part of my jaw area. Put trismus into the mix and its nearly impossible to even get fitted for dentures.

Another reason some patients do not have teeth after they are removed is the insurance companies claim dentures are cosmetic and wont cover the cost.

Take care of your teeth, brush after every meal and when you get up in the morning and before you go to bed. Dont forget to floss too. Get and use the flouride trays every single day. By taking impeccable care of your teeth and gums, hopefully you will not have any future dental issues.

Why do you think dental issues are "virtually imminent"? I had good oral hygiene and good teeth going in and I have never had any Tx related problems post Tx. I would follow up on the trays as my dentist started me wearing them 1 month pre Tx and FINALLY said I could stop after my 5th year post Tx.

I think a lot of it is diet too - high sugary foods, also saliva - since it generally helps with plaque (sp?)and finally where the rads is aimed... Oral cavity vs throat and esophagus. Though I must say they cooked my mouth but - I'm like you David - good hygiene - and tray use do make a difference. It's only been a little over 2 years for me but so far so good - I would plan on doing whatever you can to keep your teeth. Some people do get implants later but that requires a stable jaw... Etc..

David,

As I read through the archives and other sources your experience seemed to be the exception - particularly for those out a few years. Side note: reading the archives and your responses is what prompted me to ask where the trays were since they took impressions right before Tx.

Anyway - the advice from both is sound to take care of what I have, but it sounds difficult at the least to get implants or dentures physically if we start having problems? Unfortunately for us the comment on the cost makes sense if insurance will not pay.

Jasper

Cheryl,

Nice to hear you are having success. I think they are cooking my jaw fairly well to get at the nodes and surrounding area. I had what they called a cluster of nodes on the right side with some spread to the left. The tumor at BOT only showed up on PET - not visible with the scope.

Jasper

John's dental oncologist says that any teeth extracted before Tx will take a year to really heal -- yes, the piece of skin grows back over it, but the hole under remains. Maybe that is why we have not heard much about implants or replacing the teeth but much about extraction. While John now has been cleared to go back to his own dentist, he has been advised to go back to the dental oncologist if ever any work requiring a scalpel is needed.

I know a few people,with successful implants - depends,on the state of your jaw.

That is good to know. Sounds like my plan of action is to:

1. Take care of the teeth I have (good shape going into this).
2. Hope (along with good nutrition) for good bone health.
3. Save up in preparation for insurance denials.

About sum up what I can control? Does number 1 above include finding a dental specialist now?

Jasper

Its best to find a good prosthodontist. That type of dentist should have more experience in treating OC patients. Our mouths are not the same after undergoing radiation. You should see a prosthodontist at least every 6 months for a check up.