Nearly four months after radiation I have a badly decayed tooth on my right side. I was irradiated on the left. The X-Ray shows decay going deep into the nerve. I see the hospital dentist on Monday and by good fortune have an RO appointment beforehand. I haven't discussed the issue with the dentist properly yet for various reasons but he seems to be considering extraction of this molar or less likely, root canal. He seems to be in two minds about HBOT.

If I had little radiation to the right side, do I need HBOT? If the medical people "discuss" the risks with me, should I insist on oxygen treatment. From what I can find out, it would be quite doable for me because the treatment is in a place I can drive to (nervous city driver)but it sounds like an almighty pain in terms of time taken. Could it also be overkill for the good side of the mouth?

Yes, you still should do HBO. Scatter radiation has gone on the good side of your mouth too.

As far as HBOT, I had to wait until I had a clear scan, and 6 months after treatment to do it. Some earlier reports suggested it may promote cancer, my doctors seem to think there is some type of risk, and had to visit my oral surgeon a number of times before he finally decided extractions/hbot outweghed the risk, in my case, and had spoken with my RO and ENT. If I didn't really need it, had other options, I would not have any. I read one report that says hbot doesn't promote cancer. Maybe coincidently, but in 2011, a two months after doing HBOT I had a recurrence. You may want to speak with your RO about this.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3510426/

Good luck

When you see them again, make sure to discuss all options. For example, rather than extracting, the tooth can get a root canal and can also be "ground down", forgot the official name, but basically bring the tooth down to the gum line but leave the root in place. If this works then you can avoid the HBOT treatments.

I know abut HBOT but not researched it much at all since thus far that bridge is not on the horizon, knock on wood. So far my teeth are holding up. I have had some dental work done post treatment but it was not associated with the rads.

Thanks! Saw RO and hospital dentist today. Former said I could have an extraction because the radiation (on that side?) was less than 50 gy. But I didn't have an extraction, just a filling because the tooth has settled down and it's quite a useful one for my limited eating. We've bought it a little bit more time.

The bigger part of my life right now is getting from appointment to appointment in car to Park & Ride, then buses with lots of walking thrown in.

Congrats on saving your tooth!!! Every single one is so important. You are very lucky

I'm always happy to hear about successes!

Good news! And thanks for sharing the actual radiation map can be referenced to assess if/where extraction can be done without HBOT. Good to know as this does not seem to be common knowledge.

Don

They say it's anything above 60Gy, in the mandible, maxilla, that is risk for ORN, amongst other concerns, although some doctors say above 45Gy too. Some, with primary tumors in this area do get 70Gy or so, uninvolved areas can be less, and is always best to involve the RO, as was done.

The discussions I had with the RO about dosage was 60gy and above is needed to kill the cancer. Those are average and with contouring and painting and such, a specific area probably can get less than 60 but I don't have any details on that.

I've always assumed but not read for certain that those with more rads to the jawbone are more inclined to suffer ORN later.

Not going to bother digging in that hole until the situation arises, certainly not going to fret about that until that time.