hi all

looking for advice.

22 years status post radiation for tongue cancer!! teeth are a mess! extractions are recommended for my remaining teeth. reccomending 2 implants on lower to hold denture in. Has anyone had implants after radiation??? I just need to talk to someone who has been through this. I have been told that I will be fine, however I am not sure if I believe them!!

Welcome to OCF, katsmom! Congrats on your 22 yr post cancer anniversary!!!!

Im very glad you have found our group!!! Finding dental professionals who are up to date with their knowledge about oral cancer, its brutal treatments and the effects OC treatments have on patients dental needs may be quite a challenge. Many here have seen dental oncologists which are usually not easy to find, try looking at the major comprehensive cancer centers (CCC). Also prosthodontists have had extra years of training for complex patient issues so they may be a big help. Oral surgeons do just that... they cut an d once its gone it can never be exactly hoiw it was before. Has anyone from your dental professionals discussed hyperbaric oxygen treatments (HBO) with you? Prior to having any teeth extracted post rads you should be doing 20 HBO "dives" before and 10 more immediately after the dental extraction. This is called the Marx Protocol named after Dr Marx from FL who discovered and created the process for helping OC patients. Ive done too many HBO's to count anymore and while I greatly dislike being forced to take a 2 hour rest while breathing pressurized oxygen, it really is one of the easiest procedures for OC patients. If you havent yet discussed HBO then it would be a very important conversation to have! If HBO is not done, patients risk having a much bigger problem down the road... osteoradionecrosis. Basically that is when the jawbone dies. Its very painful and must be removed in a long complex surgery. Any doc who doesnt discuss HBO with you prior to recommending extractions and/or implants is NOT familiar with treating OC patients/survivors which could put you in a very dangerous situation. After going thru rads for OC, most patients jawbones have become weakened are not able to sustain the drilling to hold dental implants. Dental issues that would normally be simple procedures for almost all patients are a very different story for those who have had OC usually with rads. There are a few members here who have been able to get dental implants, not alot but I know we do have some. Hopefully they will chime in soon with more info and advice.

Best wishes!!

Hi katsmom4,

I'll be meeting with my dental team this week to discuss implants. I've had to have six teeth extracted and three are in the front on my bottom jaw - makes it very difficult to smile and not have it show that the teeth are missing!

I'll let you know what I find out and if you could let me know what you find I would appreciate it.

Thank you

I definitely agree with Christine and would get implant advice from a dental professional who has experience with post radiation implant patients.
Not just whether it can be done, but what are the pros, cons and risks are.
I had two molar implants 6 months before I discovered my SCC. I had almost constant pain for 5 weeks, I thought something went wrong. But it did eventually heal, and the oral surgeon said all looks good from a recent x-ray. But due to the healing process, and my SCC, the posts and crowns were not installed yet.
I plan to do that in January, which would be 7 months post rads/chemo.
And I developed some tori (boney jaw growths), right in front of the implants. So I plan to be very cautious on my future dental decisions. I myself, would be reluctant to go for any more implants, but my experience is unique to me.
I don't want to scare anyone into not getting them, but I do caution, to make sure you have all the facts, and possibly a second opinion.
Everyone's situation and body are different, and maybe because I had adjacent implants, it had something to do with the prolonged pain that I did not expect.
Best wishes.

Just giving a nod of agreement what was already said! I basically waited two years to have all my teeth extracted by an oral surgeon oncologist at a CCC, which was not by choice, but was due to destruction of the teeth from a number cancer treatments. After that, I did develop ORN, osteoradionecrosis of the jaw from the extraction, even though I did HBO treatments twice (60 dives), which then required debridement and a buccal flap, which didn’t work, and then a fibula jaw replacement and graft. It didn’t end there with the non healing fibula donor site, which required another graft five months later, and weekly doctor visits for wound debridement.

It may even be suggested doing hbo dives now, which may err on the side of caution, even after all this time, and I believe I read the risk increase for ORN the more distant from treatment.

To make it short, try to involve your treatment center, especially radiation oncologist, with the treatment plan (I forget name) detailing the radiation dosage, and areas radiated, which may not have the same radiation. I was cautioned by my ENT about implants, and was supposed to see a Protodontist, but developed several problems after that, and never occurred, so it’s been two years without teeth, but at least I didn’t develop any more problems, at least with the teeth. Btw, I’m writing from my hospital bed from other issues, which are somewhat related to cancer treatments.

Good luck

I can't help with the radiation part of your question but if you need the name of a Boston area dentist who did a great job for me with removable dentures (he does permanent implants too), let me know.
I was told by Dana Farber not to do implants due to the lower jaw/gum bone loss and the need to be able to inspect the gums. My regular dentist at first said he could help but was thrown completely off by my visibly altered jaw/gum, and flunked.

I located a dentist who was highly experienced with dentures and who worked closely with the dental lab to build a denture that really works well for me. He anticipated that they needed more information than a standard impression of my mouth so he also sent them pictures to help them understand. He anticipated another potential problem that would have made the denture work poorly and engineered a correction that solves it. If you need the contact information, let me know.