Everywhere I am reading it states don't pull the bottom teeth, I am finally in a multi chamber HBO and am so confused by all the things I read I don't know if I want to go through pulling out 5 bottom teeth, plus being allergic to most antibiotics. Can anyone give me some solid advice, I am hurting and confused, thanks

Hello,

Don't be confused. HBO is not so uncommon when teeth are being extracted post radiation. HBO is done to minimize the potential for complications with the extraction. The HBO enables the bone to heal better. I've not been through it so others who have can chime in.

I have had 4 molars removed post radiation so far. The first 2 (top) were not at the "epicenter" of the radiation. The last 2 were on the bottom and one of them broke off at the gum line. All of these were removed without HBO, although I had that too. The last 2 were taken out just this year in one sitting. My dentist knows my medical history and HBO was discussed. We felt that the gum condition and blood supply was adequate�. and you are extra careful re infection (antibiotics) and make sure a nice blood clot forms.

I just wished there was a reliable test to figure out if you actually need HBO or not!? Does anybody have any input on this.

With 5 teeth I would go for HBO as well, unless they are out of the radiation field. Your RO should be able to advise you. Also, you want a dentist who is experienced to treat OC patients.
Hope this helps a little.

An option, if possible, to having tooth extractions is root canal, so you don't need HBOT, and no injury that may cause ORN. For guys, a quick indicator may be if you are able to to grow facial hair where teeth need extraction it may be ok, if not, HBOT may be needed. It also depends how far out you are from radiation. All my teeth are down to the gum lines, and my hospital is pro HBOT, so have to see about it soon, again. The reason the bottom teeth may be mentioned is ORN mostly occurs in the mandible, and understand ORN, with IMRT, is low, maybe 3%, but I'm not taking any chances, and following my doctor's advise. I had too much radiation anyway.

All the best.

I'll try to summarize the advice we were given from several sources, including a dental consult at Dana-Farber Cancer Institute in Boston with an oral surgeon familiar with post rad issues. My husband has had several root canals and one wisdom tooth extracted post radiation. All were pretty much in full radiation field.

msweet55: I do not believe there is one perfect answer, but you do need a plan. I understand that you were originally treated in Boston (MO at Dana-Farber, is that right)? With access to the medical and dental community there, I do not understand how you still do not have a plan. I understand that this is very scary. I was a wreck. What advice and options have you been given? There are only a few ways to go with this.

- only extract if no other option.

- some experts recommend to cut down teeth at the gum line. I think the teeth then have a root canal that removes the blood supply and nerves in them. The tooth or the remaining roots become ankylosed into the bone and are dead, but not a problem any longer.

- HBOT is controversial and not yet proven. Our RO recommended and ordered it.
Oral surgeon put it this way, if you don't do the HBOT and develop ORN, you'll
always question your decision. Two oral surgeons noted that they can see a better
blood supply after HBOT.

- obviously, antibiotics prior to extraction with frequent post extraction healing
checks. This should not be treated as a routine extraction.

Not facing an extraction but now one year post, I just had a root canal and a retreat of an existing root canal done last week.

From what I know about ORN the root canals seemed safe without any HBOT. Other than some slight nerve pain on the one tooth, the other had zero pain, and a bit of puffiness I was fine.

One thing worth mentioning is that if you have any infection related side effect take the antibiotics. Even though my infection was pretty mild and I watched it carefully as it went away after a few days, my dentist said later for any oral cancer patient to take the antibiotics at the most minimal sign of infection.

It did not click at the time that an infection below the gum can be the cause for potential bone issues. How stupid it did not click but I was more focused on avoiding antibiotics unless really necessary. If ever I encounter even the slightest infection in the gum/bone area I'll be heading to the dentist in a flash!
Don

Actually, this is the one time I take antibiotics prophylactically�. just make sure that you are a) not allergic to it and b) you complete the full regimen.

Hi everyone, well I finished my HBO and surgery did not get scheduled until June 20 three weeks out of HBO, I am scared to death and want to back down, I have an infection but the surgeon did not offer an antibiotic until he goes in and see the condition of my teeth and jaw. I wish I didn't have to do this

Hi msweet55,

I am relieved to hear that you were able to complete HBOT - that is great!

Three weeks out of HBO is not a problem. The beneficial effects last a long time (some say up to 5 years).

Best of luck with your surgery. Please let us know how you make out.

Lottie

Hi, i had same thing i am 6 months out of HBO and one of my teeth fell out two days ago, it left a huge hole but its almost healed now and i know that's thanks to the HBO ...

Debz