Hello folks

During September I developed a large painful lesion on the inside of my right maxilla up near the soft palate. I seemed to appear out of the blue - there are no teeth in the gum there, I don't wear dentures or drink or smoke. I completed radiation 3.5 years ago.

In October the tissue plus bone shavings were biopsied and were negative for cancer. However the area would not heal. I was thoroughly scanned (again negative for cancer, yippee) and finally the lesion was diagnosed as osteoradionecrosis.

This link to OCF main site gives details of osteoradionecrosis:

http://www.oralcancerfoundation.org/dental/dental-complications.htm

I was advised that if the area didn't heal the necrotic bone would have to be surgically removed and a free flap from the soft palate used to heal the area because of the risk of infection. This was tentatively scheduled for February. (January is vacation time in Australia).

However I am pleased to report that the lesion is now healing quickly and I can't see major surgery being necessary. It is good to know that my gums are healthy enough to recover from the trauma of biopsy, stitches etc.

My mouth and teeth were well prepared prior to radiation and I look after them well so I am surprised that this has happened.

Has anyone else had a similar experience and if so, what was your treatment?

Love from Helen

Hi Helen,

Great news...thanks for sharing. Glad to hear that you healed so well. Sorry that I have no idea what you could have had there. Maybe it wasn't actually ORN. I don't think ORN shows up spontaneously, but results after trauma to the bone, eg an extraction.

One of my partners in my practice had some healing problems after an extraction, as he had been on intravenous bisphosphonates for his cancer (multiple myeloma). The problems are similar to osteoradionecrosis. It took a long time, but did eventually heal without needing HBO.

Looking forward to meeting up with you and Meredith in February. I will contact you by email as we get closer. Sure hope that it can work out.

Happy New Year

Jerry

Hi Jerry

Thanks for your input. It is possible that the trauma was caused by a 'spur' of bone in the centre of the the lesion which was removed during biopsy.

Looking forward to meeting you and your wife in Sydney.
Happy New Year from Helen

I currently have an exposed mandible (right), my oral surgeon shaves a little off of the (radiated) bone each month to keep it from eroding my tongue (Spurs). BUT, nothing enters my mouth, everything goes into my Gtube, but that has been the case for 2 years. Not being able to salivate is what caused my problem. Could that be the root cause of yours?
Darrell

This is interesting Darrell. I DO have a very dry mouth.

It surprises me that your radiated bone grows enough every month to need shaving off. I shall certainly keep that in mind - and ask my doc. I understand that relatively healthy bone does push out areas of dead bone at times.

I wish you a peaceful and comfortable new year. I appreciate your input here.

Love from Helen

Just to add some clarification...bone "spicules" can poke through the gums at any time and are usually in an area where some surgery was done previously. Most likey an extraction. I have seen this occur as much as 20 years after a tooth was extracted, although this is rare. Most of the time it is within a year or two. They are usually very sharp pieces of bone and they form when the bone breaks during the extraction.

Jerry

I'm suprised that no one has mentioned the "miracle" of Hyperbaric oxygen treatment. I've done it twice now within 4 years before and after extractions and surgery to guard against ORN. The healing process of breathing in 100% oxygen under pressure (usually 45 ft.) is amazing. I had an exposed jawbone after surgery and within 4 "dives", it was completely covered. Anyone with oral cancer should look into it.
Marianne

Marianne,

HBO has been discussed extensively in many places on this forum, and many posters here have had it at some point after their treatment.

Cathy

I highly recommend HBO as well. My wisdom teeth I found out after the fact should have been removed before my surgery and radiation. However, I probably would not have been given the HBO treatments before they removed my wisdom teeth, so it was a win/win situation in the end. The HBO has other great effects especially at healing external surgery cars.

My husband had his original surgery in 1975 he was 29 they removed part of the roof of his mouth and performed a modified radical neck for the lymph nodes. Had full radiation dose at that time. Due to his age they didn't pull his teeth. Over several years, problems developed infections etc. due to the rad. in 1990 it was decided to pull all the remaining teeth. He was set up for 20 hyperbaric treatments to prepare for the surgery and then 20 more following surgery. everything went very well, no discomfort during the dives. It made a big difference in his preparation and his healing.