I start Radiation / Chemo mid November. I have had dental problems since childhood. I will know in a couple of days the the most likely decision to remove all my teeth 25 and 2 bridges. Can anyone give me some advise to how long before you can wear dentures, is there anything out there that is temporary before your permanente dentures ?

Tammy,
I understand your concerns--ditto dental problems from childhood--'full dentures' was suggested at 14!!!
Top-set dentures from 19, more problems, then 'bottom set' age about 29/30--a month to wait for those!! Wor roll-necks and did my own 'speech therapy' to stop myself whistling whilst teaching!
My whole life (58 now) no-one, not even my parents or kids ever saw me without my dentures til this year.
Nowadays, if the pain in my jaw is too bad, I just have to leave them out--still don't like it, my partner is totally supportive and INSISTS I do it when he knows I'm in pain, even my kids have seen it now.
First set I 'woke up wearing' after teeth removal, second lot 'had to wait a month for healing,' no temporary measures, but as I say, I thought the world would end--it didn't!!
Just did a rapid 'food-type' adjustment etc., but you have my sympathy.
Hope someone here can offer you other views.

Brenda

Brenda thanks for the info. We both have grown up with dental issues. My father had dentures at 40. I have always known that I would end up with dentures but not under these circumstances. I just realize that they have to pull the teeth prior to radiation and then wait for dentures later. I read your profile and want to thank you for all the support you give knowing your DX.

Tammy,
I hate to jump in with both feet, but I'm goin too. I have a few questions for you if you could humor me.
Why were you told to have all your teeth extracted? Who told you to do this? Are your teeth sore, loose, or decayed? Do you have gum disease (periodontal) disease? Have you been a regular attender to a dentist in recent years?
My experience has been that Oncologists recommend that patients have a comprehensive dental examination prior to chemo/radiation treatments. I extract hopless teeth as I would in any individual and then restore the others. I then formulate an individual maintenance plan that is designed to spare as many teeth as possible. I see some patients weekly during chemo/radiation. It is rare that I have to extract all reamaining teeth prior to chemo/radiation.
To answer your questions;
Temporary dentures with/without obturators can be placed immediatly after surgery by a skilled, knowledgeable prosthodontist or dentist. These can be replaced by permanent prosthesis later on (usually within three months of surgery.)
I would suggest that you get an opinion from a prosthodontist prior to consenting to extraction of any teeth to be certain that you have been given all the possibilities.

Gary, a moderator and knowledgeable OC "guru" was told to have some teeth removed. After a few opinions he opted not too and now is enjoying the use of his own teeth which were suggested should be extracted. In some cases it has to be, but please get a few opinions before you make the decision.

I hate to put you on the spot Gary, but i you can offer any advice or wisdom here I'm sure it would be welcome. Jerry I would like your opinion on this as well, if you have anything to offer. As always, I as well learn from you.

Tammy, e-mail or PM any question to me if you would like.
My thoughts and prayers are with you in your journey.

Mike

I know our dental oncologist at Hopkins, who is well-known for his expertise in the effects of radiation on the mouth, teeth, and salivary glands, once told us: "In the old days we used to extract teeth before radiation but now we restore teeth beforehand and have had few problems. I will pull no tooth without due cause!"

My husband had had periodontal disease in the past, and had a mouth full of fillings, crowns and a bridge. The dentist onc examined his teeth carefully, looked at his xrays, and pronounced them "good to go!" Of course he had a set of fluoride trays made and Barry used them throughout treatment, as well as maintaining strict oral hygiene then and afterwards. He uses these trays every night.

Barry sees his local dentist 4x a year for cleaning, is extraordinarily careful about flossing and brushing, chews xylitol gum after eating, and sees the dental onc twice a year. In two years he has had two tiny fillings, and an old crown replaced and other than that, everything is still good to go!

I agree with Dr. Mike that tooth extraction may well not be necessary, depends on whether this is just their "standard operating procedure" in which case it is a bit out-dated or whether they do carefully evaluate everyone on a case-by-case basis and your teeth, unfortunately, just do not make the grade.

Anyway, I would ask about this...

Gail

Tammy,

As said above, removing all the teeth before radiation is old school. The bottom line is, did you need all your teeth out before your cancer or is this being done because of the radiation? Although rare, there are people that come to me that do really need all there teeth out. However, I have a feeling that even though you have had problems with your teeth all your life, you were not planning on dentures and if you knew that they could be kept, you would. Am I correct?

Barry and Gary are only two OCF members that have kept their teeth through and after radiation. There are many, many more. But you ahve to realize that it will take a mjor commitment on your part to maintain your teeth which will require regular fluoride applications, extra visits to the dentist and meticulous home care. You may not be willing to do this so you have to be honest with yourself.

It can be done. As Mike said, there are many factors that go into a decision if teeth can be kept. I wouldn't take this decision lightly as once you have them out, you can't go back and you may wish you could. Also, the effects on the tissues in your mouth from radiation may delay your ability to get dentures made much longer than if you had all your teeth out and no radiation.

I hope that this has been helpful.

Jerry

Thank you for all you questions and answers. I have lived with periodontal disease for more than 15 years. Oral surgery and braces to help with my gum and teeth issues. I also have alot of bone loss. Since I was a little girl every visit to the dentist was more cavities. I have had more than 100 filling done and I have 2 old bridges. Then I here brush and floss more. Then you are brushing and flossing to much. My father had dentures at age 40 years and I knew several years ago that I would be lucky to make it to 50 denture free. I have had several opinions and they are all the same. It is good to hear feed back. Dr. Mike you can jump in with your 2 feet anytime. Anything info on temporary dentures ?

Tammy,
I assume from your last post that all of your teeth will be extracted. I offer you the following information based on my experiences in my education and in the treatment of my patients. I know that not all institutions have the same guidelines, offer the same services or have the same level of expertise in this situation. I am lucky in my region to have a Prosthodontist who limits his practice to the reconstruction of OC & H&N cancer patients, trauma patients and patients with facial deformities. He is a member of our cancer centre's tumour board and is consulted on all cases that involve the jaws and potential for tooth loss prior to surgery. He provides advice on surgical options, implants, maxillofacial reconstruction and radiation fields. He, through his 30+ years of experience in this area, also helps the surgeons decide on their surgical margins so that a stable, well fitting and comfortable prosthesis can be constructed. It is common place for transitional (temporary) dentures to be fitted after the surgery is completed while the patient is still under general anaesthetic. Sometimes these are left in place sometimes they are not. I do not know the criteria for this.
I was fortunate to have him as a professor when I was a dental student.
So, Tammy, I guess you need to find out if there is such a person in your area and if so ask about transitional denture treatment. I know in my region that it is available and is quite costly because most insurance companies don't cover transitional dentures and it is not a covered treatment under our public health care program. With that said, I know he routinely provides transitional dentures.

I hope you find this useful.
E-mail me if you have any questions.

Take care.

Mike

Dr. Mike thank you for your information.I met with my dentist to discuss my options. He has spoke to the Oral Surgeon in regards to dentures. To my surpise he is going to have dentures made for me to wear right after my extrations at no cost. they will be full dentures not temporary. He stated that I will beable to wear them for maybe 6 months and then need to have another set made. But he has found a few people due rather well with their first set. So it is a wait and see.

Tammy,
I'm glad to hear that. If I can help out along the way please ask.
You are in my thoughts and prayers, good luck and God bless!!

Mike