I'm about to get my teeth removed and immediate dentures put in. Two dentists and my oral surgeon agree that this is the best solution to my current dental problems. I am doing this now, rather than putting it off, so that everything will be well healed if the cancer recurs and radiation is needed.
Has anyone had this done? I would really like to hear about your experience with the after-effects of the surgery/extractions.

Andrea

Andrea,

I don't know about dentures, but I had to have a crown placed before surgery, then ended up needing another crown and root canal on a front tooth after surgery. When the dentist told me, I just cried. I was so sick of people messing with my mouth! So, here is a hand to hold during your Boston Teeth Party, because I know you aren't looking forward to it.

How's your tongue doing? I think I had quit biting mine because I couldn't feel it about 3 months post op, but still got tired after talking a lot.

Lisa

Immediate dentures are actually used a splints or healing templates to protect the area after the extractions and aid in the healing process. IN GENERAL, I am not a big believer in full dentures unless they are absolutely necessary. I have built hundreds of sets of dentures in my early days as a technician, in the long run I would have to say I have never met a patient with a lower full denture that was happy with it. It stays in place mostly by gravity unlike the upper denture which is held in place by suction formed between it and the palate. It resists lateral movement by pushing against the remaining residual ridge, which in general is uncomfortable. People who loose all their teeth early in life and wear dentures for many decades, often have serious problems later in life. The residual ridge is diminished in size every year that the denture is worn and pressures from mastication are transferred to the boney mandible or maxilla over the years. This causes the bones to begin to become reabsorbed and small under the loading. A point can be reached when there is not enough ridge left to resist the lateral forces of the denture making them unusable. Mandibles can become so small that they are referred to as pencil thin, and can fracture under very little loading. Please note that I am describing a worst-case scenario. These days in normal patients, a pair of implants can be placed in the canine regions of the mandible and a bar fastened between them. In the overlaying denture a clip system is employed to snap to the bar. This idea, one of many over denture retention techniques, solves much of the patient's problems. Having said that, you know that implants in radiated patients do not take well. But they do in people like you. I would explore this possibility with the doctors. If money is an issue, the roots of the two canine teeth can be left in place and a gold post and core can be made to fit them. These can be the retention devices for the over denture, much as implants would be. Snaps, bars, o-ring that slip over a ball like top on the gold post are all better than no retention device at all. Good dental prosthetics is often an issue of planning in advance. Please talk to your doctors about all this, and see what they have to say. I also would not pull any teeth unless they were compromised, particularly periodontally. Once they are gone they are gone.

Andrea, Please do explore the possibility of lower implants- I am speaking from experience- they are really great. Amy

Amy, If the periodontal health of thosse lower cuspids is good they will act as well as implants. They cut the teeth off at the gum line and then they fabricate retention devices on them just as if they were implants. Cost = 1/10 of the money. Afterall, implants are essentially artificial tooth roots when you think about it.

Andrea,

I sure would like to know what your "current dental problems" are that would make two dentists and an oral surgeon suggest full dentures. Brian has described very well the usual consequences of dentures.

I always tell my patients that full dentures are a last resort and only should be done if NO other options exist. This may be your case and it would unfair of me to make suggestions without knowing your actual situation.

If you prefer to contact me via email or you want to speak on the phone, let me know. I would be more than happy to give you my suggestions after I have all the facts.

Jerry

Jerry, Thanks for the response, I have sent you a private e-mail.

Andrea

Lisa, tongue still numb, and when I get tired my speech is pretty sloppy. Numbness in the left neck and ear makes it a challenge to put in my pierced earrings...can't feel the extra holes in my head!!! Other than that, things are pretty good, or will be once I get through this dentist thing!

Brian, Thank you for the information and suggestions. They are much appreciated!!

Amy, thanks for the suggestion, I will definitely look into this!

Jerry,

What would you suggest that I do about so-called wisdom tooth that is just now coming in? It's breaking through the surface now. I go to my consult next week with the dentist / oral surgeon team. They had mentioned it in passing on my initial office visit. They wanted to wait for the panoramic x-ray to come back before making any type of decisions.

Is this a good sign that there is "growth" in my mouth? It just so happens that it's on the same side that I had the tumor removed from and most of the radiation was focused on.

John

John- Wisdom teeth are 3rd molars so it either is a third or it is not. The question with wisdom teeth is usually related to "Is there room for it to come in?" If it is horizontally impacted or tilted forward in a manner that prevents normal eruption of it into the mouth, the practice is to remove them. Many people just do not have the room for them to come in without pushing everything else out of whack. Most people don't know that a third molar which is impacted horizontally to the extent that the crown of it is actually touching the 2nd molars roots can actually reabsorb the root from that tooth as it develops itself. Severely tilted or horizontally impacted molars are taken out by removing a small portion of the buccal plate, and then with the tooth exposed it is fractured with a small chisel and hammer or cut with a high speed drill to break it into two parts that can be then removed. Maxillary 3rd's are much easier to remove than mandibular ones because of the simple shape of the root structure. Sometimes the socket is filled with a material that accelerates the formation of a clot and healing. Because of your radiation treatments this is where issues might develop, poor vascularization of the bone in that area may cause a prolonged healing process or impede it altogether. You might also hear the words dry socket when referring to this.

While I will certainly defer to Dr. W's opinion, if there is room for it, I would avoid surgery if at all possible. If not, and it has ruptured through with a corner of it perhaps extending through the mucosa, you can develop a chronic infection, pericoronitis, and that will be a problem for you if it is prevented ( because of its position in the mandible or maxilla) from fully erupting into your mouth. Surgery should not be taken lightly since you have had radiation, and you may need to make a few dives in a chamber before the surgery. As to the ramifications of this as any kind of positive prognosticator, while many things are diminished as a result of our treatments, the eruption of third molars would happen with or without the radiation. I am surprised that they were not able to take the panorex and read it immediately right in the office. I can't think of an oral surgeon I know that doesn't have this capability.