I had radiation treatment to the tongue, and this damages the surrounding areas, including the blood vessels to the lower jaw. Reduced blood flow makes it much harder for the body to fight infection.

So my question is for other for those who are in the same situation. Have any you gotten an infection in the lower gum? If so, what was the situation and how did it turn out?

Hi Andrew,

I had numerous infections/abscesses in the gums, mainly lower, which required the use of antibiotics, pain meds occasionally, for the most part of several years, which were mainly due to rampant caries from radiation causing dry mouth, I'm sure diabetes didn't help, but was unable to have any teeth removed due to persistent recurrent cancer, and contradiction of HBOT. I was under the care, and close monitoring, weekly at times, by a cancer oral/maxillofacial surgeon, as well as my other doctors, who took panorama x-ray, oral CT, to see the extent of infection, rule out cancer, and other scans, blood work by others, and was prescribed chlorhexidine--Peridex, in addition to the antibiotics, practiced proper oral care, used dry mouth products, NeutraSal rinse too, and ultimately had all my teeth removed with the required 20/10 Marx protocol HBOT, being they were not restorable, and had no infections thereafter.

I did try to stay away from sharp textured, and other foods that would irritate or injure the mouth. I'm not too sure if infections have a role in developing ORN, as has happened after the extractions, I heard may not, as it is a cause of Injury, such as extractions, plus radiation, but that's for a doctor to say.

Doctors also don't like to mess around when it comes to infections/abscesses, which can go systemically, to the brain, heart, as I was warned, and has happened to me with other infections like thrush, so such should be treated appropriately.

Good luck, and hope this hops.

Yes, very helpful.

I didn't realize tooth removal was possible. I thought they could only be sheered off at the gum line plus root canal. Were your teeth pulled, or were they extracted a different way?

As for me, the main infection problem I have occurs after periodontal cleaning. Some areas of the gums (usually near the back) become very painful. The first time this happened the periodontist said the cleaning probably stirred up resident herpes virus. I asked what we could do and he said the immune system will take care of it. And then in about a week the pain was gone, and I assume so was the problem. It doesn't happen every time, but I got scared this past time because of the severity of symptoms. But now it feels almost all better.

Do you (or anyone else) know of antibiotics (or other steps) I should take before and after dental scaling. Or any other steps I should take?

Andrew,

My teeth were down to the gum lines, broken or chipped with the prior root canals and fillings falling out during the course of a short time. The oral surgeon basically didn't want to touch me without HBOT, which wasn't possible going through cancer treatments, and without a clear scan, which took about 2 years. All my 29 teeth were surgically removed, but you're right, other measures should be taken whenever possible to avoid extractions such as root canals.

Prior to ORN this year, my first tooth infection problem started in 2011, 3 months after radiation, in the mandible 3rd molar on the cancer side, which probably received more radiation in the mouth, which had some bone exposure, did HBOT, but didn't have it extracted due to a blood transfusion, and then a recurrence.

I have heard of taking prophylactic antibiotics, antivirals in other medical cases, but with that comes risk of resistance, other super infections, but you can ask. Maybe your blood work can be checked prior, but not sure what immune boosting strategies can be taken other than sleep, nutrition, and avoiding infections, but maybe if your wbc levels are low such cleaning can be delayed, use a lower scaling pressure, I was also told at times, more so when off antibiotics (Augmentin), to rinse my mouth out with salted warm water, and didn't always have to use chlorhexadine either.

Good luck.I had a scheduled visit tomorrow, but postponed it being the Pope is in town.

Andrew,

Have you tried Chlorhexidine (aka: Peridex, Periogard, and a few others)? It is used to treat gingivitis and periodontitis and it is by prescription only. My doctors have recommended I use it before and after certain dental procedures. It is pretty potent so they have me dilute it with water before using. It does stained my teeth, so when using it I end up with more frequent cleanings.

I've also used an antibiotic before & after some dental procedures.

And like PaulB and so many others, I also had teeth removed post-RT and had HBOT to promote healing.

[quote=Susan2992]Have you tried Chlorhexidine (aka: Peridex, Periogard, and a few others)? It is pretty potent so they have me dilute it with water before using.[/quote]

I'm going to ask for this. About how much did you dilute it?

[quote=PaulB]I was also told at times, more so when off antibiotics (Augmentin), to rinse my mouth out with salted warm water, and didn't always have to use chlorhexadine either.[/quote]

How did the Augmentin fit in. Was this only as needed, or did they do it before dental procedures.

I was rinsing my mouth with salted warm water because I know salt solution can dehydrate bacteria on contact. But they kept telling me not to bother, and so eventually I stopped. And I was insisting on antibiotic before cleaning. But my primary care doctor told me that is only for people with heart valves. So I stopped that.

After posting here, I realize I should have kept at it. And I'm going to start again.

I guess each case is different, and some of my doctors know my history better, like my oncologist, having had Staph/MRSA/cellulitis issues before, so antibiotics including pain meds, were prescribed pretty much as needed when a new infection appeared, and long term before dental surgery by the oral surgeon. This was over the course of several years, so I can't give exact figures, but it was chronic, and the oral surgeon insisted on Augmentin, which is Amoxicillan combined with clavulanate potassium over other antibiotics like just amoxicillin, different doctors had prescribed being when you're in pain you go to the nearest, and quickest person that can help you or used what I had on hand.

When I was in long term antibiotics I was told by the oral surgeon I didn't have to do the salt water rinse either, the same with chlorhexidine after a while, and that was stopped too when the infection appeared gone.

Now I just have to keep the back slowly 3rd molar open socket clean with syringe, which is going to take time due to radiation, and it's already been 10 months, with one conservative surgery failing to close it.

Post surgeries, my oral surgeon insisted I must take the Augmentin to prevent infection.

My doctor has me dilute the Chlorhexidine with water in a 50/50 ratio. If I have an irritation in my mouth, which is common for me since treatment, I'll use this for a few days and it usually clears up. Ask your doctor and see what he/she recommends.

Hey Pau;
>>Now I just have to keep the back slowly 3rd molar open socket clean with syringe, which is going to take time due to radiation, and it's already been 10 months, with one conservative surgery failing to close it. <<

Did you have this molar pulled 10 months ago? Hard to keep up with you. If so, this much time later the hole where the root was is still not healed over?

Did you do HBOT before/after the extraction?

Even a healthy mouth takes awhile to close up such a big hole.