I have not seen any reference in any of the posts I have read which validates what the RO told my husband prior to starting treatment. He told him to have his remaining lower teeth pulled (he only had 5), but that his upper teeth were fed by a separate blood supply than the lower and so he didn't feel there would be a problem with those. Has anyone else heard that?
Thanks.
Michele

They removed both upper and lower on me, but every one is different and maybe the radiation will not effect that area.
There are individuals that loose no teeth. But as I understand it that is rare.
Darrell

Michele,

If his lower teeth are in good condition, I'm not sure why they would need to pull them. However, if there are existing dental problems in that area, it's better to deal with them before radiation rather than after.

I'm one of those who has never had any teeth pulled - mine survived radiation with no problems.

Cathy

I had one tooth that didn't look too good before treatment but I was able to keep it after the dentist did some filling on it. I had a thorough dental wash before the radiation to minimize the problem of tooth decay. Like Cathy, I still have all my teeth with me today although without sufficient saliva, they need extra care. I believe it is not really rare that patients don't lose any tooth. It is worth keeping the tooth unless the doctor feels it absolutely necessary to take it out but he needs to give sound reasons to support his decision.

Karen

Michelle,
Unless the teeth are absolutely hopeless, don't let them pull them. Plenty people on this board have kept all of their teeth.

While I don't know all the details, it is best if teeth which are periodontally or otherwise compromised be extracted prior to radiation. Removing these after treatment could cause serious implications that may even lead to loss of the mandible itself if it got out of hand. Given these dire consequences, doctors err on the side of caution. My teeth were all healthy when I went into treatment, and I had no extractions. However I came from a strong dental background, and had above average dental hygiene and teeth in great condition. Given that this patient has only five teeth left in his lower arch (out of 16) I wonder if those other teeth were lost due to periodontal disease. If they were, it would not bode well for any dentist evaluating the patient to assume that his ability to maintain perfect hygiene and stay on top of compromised teeth, when they will be further complication factors produced by the lack of saliva in the future. Blood supply isn't going to be the issue. It will be health of the teeth in either arch today, and the patients ability, and/or desire to work extra hard to maintain his oral health after treatments, and what teeth are going to fall into the field of radiation. For five remaining teeth I think the better long term solution would be a full denture which surely would allow him to function better when this was all over.

Michele, first off, to answer what I believe was your primary question, here is a link to some diagrams showing that in fact there are two separate blood supplies for the upper and lower teeth. http://www.sadanet.co.za/dhw/owners_manual/anatomy3.html

Following that, it is possible that there was/is no need to remove any upper teeth as they likely will not be in the beam of radiation. In my case that was what happened, as I only had one upper tooth removed but three lower teeth. Also, my regular dentist too exception to the oral surgeon's plan and in talking with him saved one of my lower teeth. Do not just accept their plan as a cast in stone, ask why.

Bill

Thanks for the replies. My husband, Jesse, did have periodontal disease in the past and as a result, had what is called splints on both upper and lower gums (I guess it is a replacement for damaged bone that helps to hold the teeth in). The RO told him to have his lower 5 remaining teeth pulled, which he did prior to the start of radiation. He indicated that the upper would not be a problem, as it was fed by a different blood supply. I took this to mean that even if he had problems with his upper teeth resulting from radiation, that it would not be a problem to have them worked on, whereas, if he had problems with his lower teeth, it would result in major problems, as Brian had mentioned, with the possibility of loss of the mandible. He did not recommend that he treat his upper teeth with daily fluoride rinse or make any other recommendations about specific care of his upper teeth. Although his upper teeth were in about the same shape as his lower. No cavities, but still had the splints from years before. I am hoping that if there are problems with the upper teeth, that it will not result in further complications. I would assume, from what the RO insinuated, that to have upper teeth removed after radiation would not be a problem, whereas, to have the lower teeth worked on and/or removed, would be a problem. I just thought it was odd that I didn't see anyone else on this forum make any reference to any difference between the upper and lower. I will hope our RO was correct.
Thanks so much.
Michele