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#188597 03-06-2015 11:50 AM
Joined: May 2010
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MikeC Offline OP
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So... about to switch on annual scans after slowing scaling out the frequency over the last five years.

Yesterday I had a front lower tooth completely break off at the gum line... no pain. The tooth was dead. Most likely from the radiation. Makes me really worried about the cost and what options might be if they're all going to do that over time.

Depressed and stressed out over this...

I had to cancel a trip to a conference where I was supposed to be giving presentations. Lost $200 canceling my wife's ticket to go with me. The conference was going to be in Miami, so a chance for both of us to escape was has been a wet, cold, dark, gloomy, depressing winter in Texas. I know, not like we live in Boston, but it's not been any picnic here either...

Just when you think things are behind you - now what I am about to get myself into??

I've already been told I am not a candidate for implants because of the radiation.

Bummed in Texas.


Survivor. 55yr male. Dx 07/09 SqCCa Stage IV, Rt Tonsil, Lt&Rt Lymph Nodes. Aborted tonsilectomy 07/09. Chemo port 07/09. PEG 09/09. Chemo - 3xCisplatin 6xErbitux. RTx35. Tx ended 11/09. CAT scan (clean) 01/10. PET scan (clean) 02/10. Port & PEG removed 04/10.
Joined: Nov 2009
Posts: 644
Likes: 1
"OCF Down Under, Kiwi"
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"OCF Down Under, Kiwi"
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The dental aspects are awful. Will your insurance pay for a denture?

I'm getting free but very slow treatment to replace broken teeth in the form of partial metal dentures. My remaining teeth act as anchors. It's free because I'm in New Zealand where we don't have free dental treatment unless it's a serious oncology issue like mine. Unless it's a medical issue carried out in a hospital.

My former temporary denture was all plastic-like material and could have a new tooth added quickly if one broke off. (I've had a couple break at gum line.)

A denture with one tooth is possible and could be done relatively cheaply and quickly for cosmetic effect. Wouldn't be the most comfortable of things to have in your mouth but could be good for temporarily use while you and your dentist consider future options.

Sorry about the horrible winter but have to admit I'm sick of summer (sacrilege) because it has been so damn hot and humid with no respite. Kind of atypical for NZ where we generally have variable weather patterns.



1996, ovarian cancer surgery + cisplatin and taxol.
September, 2007, SCC of left lateral tongue. Excision.
October, 2009 recurrence in scar tissue, T1NOMO. Free flap surgery from left wrist - neck dissection. 63 year old New Zealander. No chemo, no RT.
February, 2014. New primary in left buccal mucosa. Marginal mandibulectomy, neck dissection, right arm free forearm flap. T1N0M0 but third occurrence and some areas of concern: RT started 8 April and finished 19 May.
Joined: May 2010
Posts: 61
MikeC Offline OP
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I'm not sure what will happen insurance wise. I have dental coverage, but it only covers basic cleanings, etc. To me, this should be covered by major medical, as it is 100% a direct cause of the radiation. I have major medical, and I have a small cancer rider insurance policy that I will also file on. But no guarantee that either will pay anything. I will out of pocket for thousands of dollars up front...


Survivor. 55yr male. Dx 07/09 SqCCa Stage IV, Rt Tonsil, Lt&Rt Lymph Nodes. Aborted tonsilectomy 07/09. Chemo port 07/09. PEG 09/09. Chemo - 3xCisplatin 6xErbitux. RTx35. Tx ended 11/09. CAT scan (clean) 01/10. PET scan (clean) 02/10. Port & PEG removed 04/10.
Joined: Dec 2003
Posts: 2,606
Likes: 2
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MikeC, you're screwed. It is going to be costly and most likely out of pocket. I had the same thing happen around year 4 while biting into a chip at Tupinamba. Better get into someone that knows what they are doing. You have two choices in the area. Round 1 cost me around $20,000 and I never did Round 2.

As bad as it seems today, try to process your grief in something that is somewhat of a lifechanger and get a plan in place. My teeth have done well since those dark days with no issues since. That was 7 years since Round 1.

Hang in there.


SCC Stage IV, BOT, T2N2bM0
Cisplatin/5FU x 3, 40 days radiation
Diagnosis 07/21/03 tx completed 10/08/03
Post Radiation Lower Motor Neuron Syndrome 3/08.
Cervical Spinal Stenosis 01/11
Cervical Myelitis 09/12
Thoracic Paraplegia 10/12
Dysautonomia 11/12
Hospice care 09/12-01/13.
COPD 01/14
Intermittent CHF 6/15
Feeding tube NPO 03/16
VFI 12/2016
ORN 12/2017
Cardiac Event 06/2018
Bilateral VFI 01/2021
Thoracotomy Bilobectomy 01/2022
Bilateral VFI 05/2022
Total Laryngectomy 01/2023
Joined: Nov 2009
Posts: 644
Likes: 1
"OCF Down Under, Kiwi"
"Above & Beyond" Member (500+ posts)
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"OCF Down Under, Kiwi"
"Above & Beyond" Member (500+ posts)

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Posts: 644
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It is a medical issue caused by radiation so head and neck cancer patients form a special group of dental patients. Here in NZ patients who had their own dentition during treatment are NOT funded for the dental surveillance they need for the rest of their lives. This is a big issue with head and neck groups around the country. In a way I'm "lucky" because I'm getting free treatment on account of major issues. If I survive the hospital might fling me out to take my chances with my local dentist. This problem is a "survivorship" issue. People damn well survive. How does the medical system deal with this long term survivorship? The specialist nurse at my hospital said there is some good material at MD Anderson in relation to future survivorship problems.



1996, ovarian cancer surgery + cisplatin and taxol.
September, 2007, SCC of left lateral tongue. Excision.
October, 2009 recurrence in scar tissue, T1NOMO. Free flap surgery from left wrist - neck dissection. 63 year old New Zealander. No chemo, no RT.
February, 2014. New primary in left buccal mucosa. Marginal mandibulectomy, neck dissection, right arm free forearm flap. T1N0M0 but third occurrence and some areas of concern: RT started 8 April and finished 19 May.
Joined: May 2010
Posts: 61
MikeC Offline OP
Supporting Member (50+ posts)
OP Offline
Supporting Member (50+ posts)

Joined: May 2010
Posts: 61
I saw my oncology dentist this morning. He has to get all of my treatment information from my radiologist before he can determine what the treatment plan will be. I'm in limbo for now.


Survivor. 55yr male. Dx 07/09 SqCCa Stage IV, Rt Tonsil, Lt&Rt Lymph Nodes. Aborted tonsilectomy 07/09. Chemo port 07/09. PEG 09/09. Chemo - 3xCisplatin 6xErbitux. RTx35. Tx ended 11/09. CAT scan (clean) 01/10. PET scan (clean) 02/10. Port & PEG removed 04/10.
Joined: Dec 2003
Posts: 2,606
Likes: 2
Patient Advocate (old timer, 2000 posts)
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Patient Advocate (old timer, 2000 posts)

Joined: Dec 2003
Posts: 2,606
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MikeC, mind me asking who you are seeing?


SCC Stage IV, BOT, T2N2bM0
Cisplatin/5FU x 3, 40 days radiation
Diagnosis 07/21/03 tx completed 10/08/03
Post Radiation Lower Motor Neuron Syndrome 3/08.
Cervical Spinal Stenosis 01/11
Cervical Myelitis 09/12
Thoracic Paraplegia 10/12
Dysautonomia 11/12
Hospice care 09/12-01/13.
COPD 01/14
Intermittent CHF 6/15
Feeding tube NPO 03/16
VFI 12/2016
ORN 12/2017
Cardiac Event 06/2018
Bilateral VFI 01/2021
Thoracotomy Bilobectomy 01/2022
Bilateral VFI 05/2022
Total Laryngectomy 01/2023
Joined: May 2010
Posts: 61
MikeC Offline OP
Supporting Member (50+ posts)
OP Offline
Supporting Member (50+ posts)

Joined: May 2010
Posts: 61
Dr. Dennis Abbott in Garland. I met him via the dental center in the Baylor Sammons Cancer Center, at big Baylor in downtown Dallas. But his private practice is in Garland, on Beltline Rd just off I-30.


Survivor. 55yr male. Dx 07/09 SqCCa Stage IV, Rt Tonsil, Lt&Rt Lymph Nodes. Aborted tonsilectomy 07/09. Chemo port 07/09. PEG 09/09. Chemo - 3xCisplatin 6xErbitux. RTx35. Tx ended 11/09. CAT scan (clean) 01/10. PET scan (clean) 02/10. Port & PEG removed 04/10.
Joined: May 2010
Posts: 61
MikeC Offline OP
Supporting Member (50+ posts)
OP Offline
Supporting Member (50+ posts)

Joined: May 2010
Posts: 61
They say I am not an extraction candidate because of the radiation. I don't really understand that... will talk to them again... but root canal on the broken tooth, and new lower bridge. They will write a letter as to the cancer/radiation being the cause, but you have to file it with your major medical and/or cancer policy yourself. So yep, up front and mostly out of pocket. US dental insurance is a joke - it doesn't doesn't pay for much other than basic cleaning and checkups.


Survivor. 55yr male. Dx 07/09 SqCCa Stage IV, Rt Tonsil, Lt&Rt Lymph Nodes. Aborted tonsilectomy 07/09. Chemo port 07/09. PEG 09/09. Chemo - 3xCisplatin 6xErbitux. RTx35. Tx ended 11/09. CAT scan (clean) 01/10. PET scan (clean) 02/10. Port & PEG removed 04/10.
Joined: May 2013
Posts: 134
Senior Member (100+ posts)
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Senior Member (100+ posts)

Joined: May 2013
Posts: 134
Dennis Abbott is THE Man! Lots of horror stories of well-meaning docs not up to speed on radiation effects getting in trouble.


Dx March 2011 via FNA (49 yrs old)
SCC BoT
HPV+ exact strain unknown
Stage IVa T3N2cM0
Cisplatin x 3, IMRT x 40 (7267 cGy)
One node removed post-treatment (rad dmg)
Clean PET 10/28/11
Swallow therapy
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