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Major dental problems after radiation #200459
10-04-2020 12:49 PM
10-04-2020 12:49 PM
Joined: Dec 2017
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mrsdranchak Offline OP
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mrsdranchak  Offline OP
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I am post treatment almost 2 years. About a year after radiation ended, my teeth began to stain badly at the jawline. The dentist said it was rapid decay as a result of the radiation. The radiatio oncologist never advised this could be a post treatment problem. I am 64 and had perfect teeth, never a cavity.

About a week ago i lost most of a tooth and part of another has broken off. Dentist warned me I would have to have teeth removed and get dentures.

Is it dangerous to have my teeth removed? Should I just let them fall out naturally I look like a meth addict?

Has anyone been successful in getting medicare to cover after radiation? I talked to Medicare and they said if the surgeon said there was a medical reason for the removal it would be covered.

Im sick of cancer continuing to be such a major part of my life. Dont get me wrong -- I'm so grateful to be alive. I have come to grips with my major speech impediment and my inability to eat many food (i cant taste much anyway). But I want to be proactive and get this issue behind me.


MrsDranchak
Re: Major dental problems after radiation [Re: mrsdranchak] #200461
10-05-2020 02:30 AM
10-05-2020 02:30 AM
Joined: Jun 2019
Posts: 212
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Dizz_zzey Offline
"OCF across the pond"
Dizz_zzey  Offline
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As far as I'm aware, it is not dangerous to have teeth removed so long after rads as you will heal better now. During rads, and up to 6 months after, it takes a long time for your body to heal because rads is so brutal on the system.

Get them taken out professionally as you are less likely to have infection. Whereas leaving broken or rotting teeth to fall out naturally can cause so many issues. Before my cancer I broke a tooth on a hard nut. Part of the tooth broke off and cut my tongue quite badly, and part of my gum. It was painful.

Your dentist will also be able to offer advise on how to keep the rest of your teeth.


F 39 x-smoker,non drink
05/20/19 T4aN1/N2bM0 SCC L lateral tongue &10mm into R
Pembro pre & post surgery
RIG 08/10/19
Glossectomy ND RFFR 08/13/19
RT x33
2x cispltin
No doing too bad smile
Re: Major dental problems after radiation [Re: Dizz_zzey] #200462
10-05-2020 12:46 PM
10-05-2020 12:46 PM
Joined: Oct 2008
Posts: 232
NY state
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travelottie Online
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travelottie  Online
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Joined: Oct 2008
Posts: 232
NY state
Removing teeth post-radiation therapy is a risk due to the possibility of developing ORN (osteoradionecrosis) resulting from compromised blood flow to the jaw. If you check my past posts on this topic, you will see that it is a complicated decision. My husband did not get good advice until he consulted a dental surgeon who was part of an oral cancer team. I would not proceed with dental extractions until seeing a dental surgeon with experience treating oral cancer patients.

There are many factors to consider. The dental surgeon should review a mapping of your radiation dose targets. This is obtained from your radiation oncologist in order to check the high-dose areas of radiation in relation to the teeth that are being considered for extraction.

I know it's a lot to absorb. The OCF pages under dental issues are helpful and your radiation oncologist should be able to give you some guidance.
All the best,
travelottie


CG to husband, dx @ age 65, nonsmoker/social drinker. Dx 5/08 SCC Stage IV, BOT T1N2aM0. 33 IMRT - completed 9/12/08. Induction Chemo (Cisplatin, Taxotere & 5FU), plus concurrent Cisplatin.
1/09 PEG removed; 5/09 neg PET/CT; 5/10 PET/CT NED
Dental extraction & HBOT 2013; ORN 2014; Debridement/Tissue Transfer & HBOT 2016
Re: Major dental problems after radiation [Re: travelottie] #200463
10-05-2020 01:04 PM
10-05-2020 01:04 PM
Joined: Jun 2019
Posts: 212
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Dizz_zzey Offline
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Dizz_zzey  Offline
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Joined: Jun 2019
Posts: 212
Ahhh thank you. The hospital dentist has clearly not been giving me enough information (well pretty much not a lot)
I'm now with a different dentist for my dental care who has worked with OC patients and has asked if he can consult my team with some treatment I need to have done. It's going to cost me a bit, as the hospital dentist is free, but he makes me feel valued and gives me a lot more information than I've been given.

I will challenge him about a tooth removal I need to have done, whether he has contacted my medical team or not.


F 39 x-smoker,non drink
05/20/19 T4aN1/N2bM0 SCC L lateral tongue &10mm into R
Pembro pre & post surgery
RIG 08/10/19
Glossectomy ND RFFR 08/13/19
RT x33
2x cispltin
No doing too bad smile
Re: Major dental problems after radiation [Re: travelottie] #200471
10-09-2020 05:05 AM
10-09-2020 05:05 AM
Joined: Oct 2014
Posts: 4
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LaurenKuhlmeier81 Offline
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LaurenKuhlmeier81  Offline
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Joined: Oct 2014
Posts: 4
I’m 16 yrs out and experienced many dental issues and agreed pulling your teeth is something you do Not want to just jump into without consulting several dentists/ oral surgeons that have experience with oral cancer patients. I’m only 39 and have had Hyperbaric Oxygen Chamber treatments to help but the threat of osteonacrosis is still extremely high. Whatever decision you make I wish you all the luck but please do not just jump into removal and find a way to get it coded as medical, that will help with the bills.

Re: Major dental problems after radiation [Re: mrsdranchak] #200491
10-14-2020 10:27 AM
10-14-2020 10:27 AM
Joined: Jan 2006
Posts: 755
Pennsylvania
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Susan2992 Offline
"Above & Beyond" Member (500+ posts)
Susan2992  Offline
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Joined: Jan 2006
Posts: 755
Pennsylvania
I had radiation in 2006 and I’ve had numerous dental issues since then. I believe I posted about them on this forum.

HBOT is a must post-radiation. The Marx Protocol calls for 20 “dives” (HBOT treatments) before an extraction, and 10 “dives” afterwards.

Insurance is always a challenge for us and dental issues. Extractions and HBOT should be covered, but not sure about dentures. In the USA extractions are generally done by someone in the dental field and some things are covered by dental insurance and others by your medical insurance.


Susan

SCC R-Lateral tongue, T1N0M0
Age 47 at Dx, non-smoker, casual drinker, HPV-
Surgery: June 2005
RT: Feb-Apr 2006
HBOT: 45 in 2008; 30 in 2013
Recurrence/Surgeries: Jan & Apr 2010
Biopsy 2/2011: Moderate dysplasia
Surgery 4/2011: Mild dysplasia
Dental issues: 2013-2020
Re: Major dental problems after radiation [Re: mrsdranchak] #200493
10-18-2020 02:41 PM
10-18-2020 02:41 PM
Joined: Aug 2019
Posts: 16
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Thankful Girl Offline
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Thankful Girl  Offline
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Joined: Aug 2019
Posts: 16
My radiologist and my dentist both told me that if I ever needed any teeth extracted I would need to have 20 HBO treatments before extraction, and ten following. This is to build up blood in your radiated jaw so that you don't suffer jaw deterioration. I can't even imagine that after all we've dealt with, and are dealing with. My medical insurance absolutely covers it. I live in the USA.

My radiologist also mentioned the benefits of HBO therapy for over all radiation injury, not just for tooth extractions, which I didn't need. I am 1 year, 7 months post radiation. I did 60 treatments this Summer. Mon - Fri for almost two hours in the chamber every morning for six weeks. My medical insurance covered it. Now we all know what the #1 saying is for oral cancer patients. "Everybody's different." But, I must share. I completed my last treatment two weeks ago. By no means is it a cure all, for me anyway. What it DID do for me is reduce swelling I had in my throat and mouth. After about 1/2 way through I had people close to me start telling me how much better I was sounding. I didn't realize how abnormal I sounded. Three different people mentioned I used to sound deaf. Not anymore. My speech is back to normal. As I said, we're all different in that we have various types of oral function loss. I still have pretty severe xerostomia, dry throat.(I had 4 out of 6 salivary glands removed. Unfortunately the ones removed were the most productive ones.) I cannot eat normally at all. Pretty much liquids or salads, some pastas. The HBO treatment helped my swallowing immensely. Before treatment, food and liquid would get stuck in the top of my throat and sometimes want to go down the pipe. That problem disappeared. I know my saliva glands are producing at least a little bit more because I'm not needing to drink as much water. Another thing I am really glad about is now that I have done these dives I won't need to any more if I do have teeth issues in the future. When oxygen builds the blood cells, they're permanent.

Just wanted to share that with you. I've learned a lot just reading fellow OC patient's posts. Anything little thing that can improve our quality of life I am happy to read and send. I do hope you're able to get HBO for your teeth. Take Care!

Re: Major dental problems after radiation [Re: Thankful Girl] #200499
10-20-2020 12:22 PM
10-20-2020 12:22 PM
Joined: Jun 2019
Posts: 212
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Dizz_zzey Offline
"OCF across the pond"
Dizz_zzey  Offline
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Gold Member (200+ posts)
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Joined: Jun 2019
Posts: 212
Hmmm I need to speak to my hospital to see if they will refer me for HBOT, otherwise I'm spending £120 (about $140) per hour session.

Thank you so much for the information. Teeth weren't mentioned apart from keep them clean and have plenty of fluoride.


F 39 x-smoker,non drink
05/20/19 T4aN1/N2bM0 SCC L lateral tongue &10mm into R
Pembro pre & post surgery
RIG 08/10/19
Glossectomy ND RFFR 08/13/19
RT x33
2x cispltin
No doing too bad smile

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