I'm starting a new thread that is a continuation of the progressive dysphagia saga. My husband was diagnosed in 2008 with stage IV oropharyngeal (base of tongue) SCC, treated with chemo-radiation.

Recent swallow test confirms high-risk for aspiration. Nothing by mouth is not yet recommended, as he is able to protect his airway sufficiently for now.

How is dental work performed in this situation? I'm thinking about high speed drills that squirt large amounts of water to keep them cool, pooling saliva even during routine cleaning, etc. I don't remember seeing this discussed on the forum. I hope that some of you in this difficult situation will respond. I believe that Brian would have personal and professional expertise in this matter.

The adjustments required to deal with treatment side effects are exhausting!
Lottie

I had SCC back in 2009, chemo/ radiation cleared it up, but left my mouth a mess. I have had the same dentist for 20 years and they were very accommodating with me. I am NPO and aspirate all the time They stop when I start to gag and I do have trismus from the radiation and they do deal with my smaller mouth opening. Your question is important as all of have "weaker" teeth since radiation. I am diligent about my care and get my teeth cleaned 3x a year. It is just one more hurdle we have to jump over.

Steve

Thanks again, Steve. My husband gets his teeth cleaned every 3 months. His dentist is well aware of the situation. In the past he underwent debridement and tissue transfer after an extraction that could not avoided. This was done by oral surgeon on an oral cancer team at Mt. Sinai Hospital, NYC and that has remained stable.

Now that he is dealing with progressive dysphagia, a small cavity needs repair. I'm having trouble picturing how this can be worked on without aspirating and developing pneumonia.

I am 100% NPO. I did get aspirated pneumonia back in my "dumb" days when I was eating. I have had a lot of dental work lately. As I mentioned, they are always ready for my coughs!!!. Als0. I could be wrong about this but I think aspirated pneumonia is most often food stuff going into your lungs. Of course saliva can cause it but maybe rinsing with germ killing mouthwash before the dental work begins will lessen the chance the problem. Talking to the dentist with your concerns may be a great first step.

I hope it turns out fine for your hubby
Steve