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Today is 5 years since Bob completed treatment! It should be a good day, but it is not. He has an abscessed wisdom tooth, on radiated side, that his general dentist does not think can be saved. I've been in touch with his RO. I'm familiar with the hyperbaric protocol and have read that an extraction can be life threatening.

I made an appt for Monday with a great endodonist to get a second opinion and with an oral surgeon on Wednesday. I may contact Dana Faber's dental department (we had a consult with H&N team there five years ago and they agreed with proceeding with local tx plan).

I'm especially worried that it's a wisdom tooth - the largest roots, etc. I feel all the panic returning....

Thank you for all the support and information over these years. I think about all of you and keep updated on posts, but have recently taken a break and tried to enjoy our new life.


CG to husband, dx @ age 65, nonsmoker/social drinker. Dx 5/08 SCC Stage IV, BOT T1N2aM0. 33 IMRT - completed 9/12/08. Induction Chemo (Cisplatin, Taxotere & 5FU), plus concurrent Cisplatin.
1/09 PEG removed; 5/09 neg PET/CT; 5/10 PET/CT NED
Dental extraction & HBOT 2013; ORN 2014; Debridement/Tissue Transfer & HBOT 2016
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Congrats on the 5 year anniversary!

When having extractions done after rads, ask about doing hyperbaric oxygen treatments. They are time consuming but that will hopefully prevent far worse issues down the road. OC patients should be doing the Marx Protocol (20 dives prior to extraction and 10 after).

If you have questions about HBO, let me know.

Good luck!



Christine
SCC 6/15/07 L chk & by L molar both Stag I, age44
2x cispltn-35 IMRT end 9/27/07
-65 lbs in 2 mo, no caregvr
Clear PET 1/08
4/4/08 recur L chk Stag I
surg 4/16/08 clr marg
215 HBO dives
3/09 teeth out, trismus
7/2/09 recur, Stg IV
8/24/09 trach, ND, mandiblctmy
3wks medicly inducd coma
2 mo xtended hospital stay, ICU & burn unit
PICC line IV antibx 8 mo
10/4/10, 2/14/11 reconst surg
OC 3x in 3 years
very happy to be alive smile
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Thank you, as always, Christine. I am aware of hyperbaric treatment from this forum. I will check back with you about Marx Protocol, once we get a few more opinions.

I am very upset because I think wisdom teeth on the radiated side should probably have been extracted prior to tx in order to eliminate the possibility of this complication. I didn't know that 5 years ago and his teeth were in great shape at the time.


CG to husband, dx @ age 65, nonsmoker/social drinker. Dx 5/08 SCC Stage IV, BOT T1N2aM0. 33 IMRT - completed 9/12/08. Induction Chemo (Cisplatin, Taxotere & 5FU), plus concurrent Cisplatin.
1/09 PEG removed; 5/09 neg PET/CT; 5/10 PET/CT NED
Dental extraction & HBOT 2013; ORN 2014; Debridement/Tissue Transfer & HBOT 2016
Joined: Oct 2008
Posts: 247
Likes: 1
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Just spoke to Dana-Farber & Brigham & Women's Hospital dental office. Dentists on staff there only see patients who are currently undergoing tx.

I asked if they referred to dentists experienced with H&N cancer and was told there is no such thing. Our general dentist thought he was sending Bob for a more or less routine extraction evaluation with an oral surgeon. Of course, we knew to contact RO. In the past, RO did not have dental referrals either.

Anyone aware of how to locate someone with experience, if an extraction is necessary? RO will set up hyperbaric therapy.

Bob is on antibiotics, the pain was never severe, and he sees a great endodontist on Monday.

Thank you,
Lottie


CG to husband, dx @ age 65, nonsmoker/social drinker. Dx 5/08 SCC Stage IV, BOT T1N2aM0. 33 IMRT - completed 9/12/08. Induction Chemo (Cisplatin, Taxotere & 5FU), plus concurrent Cisplatin.
1/09 PEG removed; 5/09 neg PET/CT; 5/10 PET/CT NED
Dental extraction & HBOT 2013; ORN 2014; Debridement/Tissue Transfer & HBOT 2016
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I saw the oral surgeon at my treatment center yesterday, which appointment I made when I was NED, but have to go back after my current recurrence is dealt with. I did have HBO before, which my local MO made the arrangements for at a local hospital,, and seen an oral surgeon to have an extraction, who was experienced with cancer patients, but my dentist was not aware of HBO in previously irridated patients i think if he just sentnme to have an extraction. I would think any hospital's otolaryngology department oral surgeon is cancer experienced, and can be found by calling hospitals, searching yellow pages. Another is U.S. New's reports best hospitals, and go to Ear Nose, and throat, and will have a listing of the top rated hospitals. link to the hospital, and see meet the physicians or staff. If not accepted there, many docirs also have a private practice, and can go there instead, There is another listing of Best Doctors in America, by Connelly something, forget full name, which doctors have a gold star next to their name in thr US News Report listing or google best oral surgeons Connely, but get the proper name.

It's Castle Connolly Best Doctors

Good luck.


10/09 T1N2bM0 Tonsil
11/09 Taxo Cisp 5-FU, 6 Months Hosp
01/11 35 IMRT 70Gy 7 Wks
06/11 30 HBO
08/11 RND PNI
06/12 SND PNI LVI
08/12 RND Pec Flap IORT 12 Gy
10/12 25 IMRT 50Gy 6 Wks Taxo Erbitux
10/13 SND
10/13 TBO/Angiograph
10/13 RND Carotid Remove IORT 10Gy PNI
12/13 25 Protons 50Gy 6 Wks Carbo
11/14 All Teeth Extract 30 HBO
03/15 Sequestromy Buccal Flap ORN
09/16 Mandibulectomy Fib Flap Sternotomy
04/17 Regraft hypergranulation Donor Site
06/17 Heart Attack Stent
02/19 Finally Cancer Free Took 10 yrs






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Thank you PaulB for responding, especially while you are dealing with your own treatment challenges. I will check out these suggestions.

Regarding ENTs, not sure if that is a better option for an extraction, (certainly more experienced with cancer). I think someone once asked on the forum - do ENTs or oral surgeons have more experience with teeth...

A dentist working in a H&N cancer center (we could go to NYC or Boston for a consult) must refer to certain skilled oral surgeons/dentists in the area - how to get that info???

Maybe I need to go back and inquire about oral surgeons at Dana-Farber.



CG to husband, dx @ age 65, nonsmoker/social drinker. Dx 5/08 SCC Stage IV, BOT T1N2aM0. 33 IMRT - completed 9/12/08. Induction Chemo (Cisplatin, Taxotere & 5FU), plus concurrent Cisplatin.
1/09 PEG removed; 5/09 neg PET/CT; 5/10 PET/CT NED
Dental extraction & HBOT 2013; ORN 2014; Debridement/Tissue Transfer & HBOT 2016
Joined: Jul 2012
Posts: 3,267
Likes: 4
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I don't think ENT's do teeth extractions. An Oral and Maxilofascial Surgeon would. HBO is not everywhere, but that can be done locally, if available, do extractions wherever, continue HBO. I know I can have it where I live at one location, and did before. It's expensive, like $2,000 a day, but insurance paid for it.


10/09 T1N2bM0 Tonsil
11/09 Taxo Cisp 5-FU, 6 Months Hosp
01/11 35 IMRT 70Gy 7 Wks
06/11 30 HBO
08/11 RND PNI
06/12 SND PNI LVI
08/12 RND Pec Flap IORT 12 Gy
10/12 25 IMRT 50Gy 6 Wks Taxo Erbitux
10/13 SND
10/13 TBO/Angiograph
10/13 RND Carotid Remove IORT 10Gy PNI
12/13 25 Protons 50Gy 6 Wks Carbo
11/14 All Teeth Extract 30 HBO
03/15 Sequestromy Buccal Flap ORN
09/16 Mandibulectomy Fib Flap Sternotomy
04/17 Regraft hypergranulation Donor Site
06/17 Heart Attack Stent
02/19 Finally Cancer Free Took 10 yrs






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Hi Travelottie,

I see you got some great advice. And maybe this is not the best time, but I just want to say that seeing your husband as a 5 year survivor of BOT is encouraging and I appreciate the fact you are here and share your experiences. I am only 2 years out BOT, age 50, but it's been a long two years and I can hear in your voice the same way my wife sounds at times. It's great to have caregivers such as yourself (and my wife) around ....

Whispered a prayer you and your husband get through all this with little to no side affects ...it's not much to offer, but it's all I got though I wish I could do more ...


Timothy1963

Stage III HPV16+ Base of Tongue: DX Oct 2011 - TX were Erbitux and Radiation Only. Last TX was Jan 2012
To Date: NED
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timothy 1963,

Thank you for your kind and thoughtful words. My husband has actually recovered better than I initially anticipated - working out at gym, traveling (which was always a major activity for us), and eating fairly normally (with some improved saliva production as late as 4 years out). There is much hope for others in this outcome.

Each time a new side effect becomes a problem, the panic starts to return, until I get a plan in place. Endodontist evaluation this PM will start the process.

Lottie


CG to husband, dx @ age 65, nonsmoker/social drinker. Dx 5/08 SCC Stage IV, BOT T1N2aM0. 33 IMRT - completed 9/12/08. Induction Chemo (Cisplatin, Taxotere & 5FU), plus concurrent Cisplatin.
1/09 PEG removed; 5/09 neg PET/CT; 5/10 PET/CT NED
Dental extraction & HBOT 2013; ORN 2014; Debridement/Tissue Transfer & HBOT 2016

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