My husband needs to find a better dentist in the Seattle, or preferably Eastside (Bellevue, Kirkland, Redmond) area. He needs a dentist with experience in following patients who have had radiation treatment and their special concerns. His oncology treatment was at Evergreen Hospital/Cascade Cancer Center, but they do not have oncologic dentists on staff. Anyone have a recommendation?
Thanks!

Hi there, I can't help you but it would be nice if someone could help us find a resource for finding dentists that have been trained in post radiation dental issues. I live in Las Vegas, NV and have had a hell of a time finding this type of dentist. Maybe Brian Hill could offer some insite if he reads this post

Trimatt, you might be able to get a recommendation from the Fred Hutchinson CC in Seattle at Tel: 206/667-4305.

Here's the list of Cancer Centers from this site for any who might need it:

http://www.oralcancerfoundation.org/resources/cancer_centers.htm

Deano, you might call a couple of CCs and see if there is some kind of Dental Oncologist referral place.

There really isn't any reason why any competent dentist can't manage your husbands dental health. You must set some requirements up front however and be your own advocate.

Extractions are a no no and must be avoided at all costs, particularly if they are in the radiation field.

If extractions are unavoidable then HBO must be considered to prevent ORN.

Some dentists will put off minor repairs for financial consideration of the patient. For cancer patients the minor repairs need to be done well before they become major issues. Careful and extremely thorough examinations are the rule.

Routine cleaning and flouride treatments need to be doubled and he should have dental trays fitted and perform at home flouride treatments with prescription flouride foam.

Also make sure that the hygenist cleans below the gumline - believe it or not, some don't. Ultrasonic scalers seem to be more efficient and thorough than manual scaling.

I still use a Water Pik, floss constantly (use woven floss) and even have a battery operated Panasonic (type of Water Pik) for travel purposes. Biotene products are excellent for dry mouth and are readliy available from most supermarket chains.

There are usually no problems with fillings, crowns or even root canals. Jerry, our resident dentist/survivor will probably elaborate some more when he returns from his vacation.

Regular x-rays and a full mouth pano every few years is a good thing as well.

These are all about prevention and meticulous dental hygiene - for life.

As a side bar, I saw a dental oncologist at a major CCC (as a requirement of my pre Tx work up) and he recommended pulling ALL of my well maintained teeth. I told him to go and screw himself. 4 years later, I still have all of my teeth and couldn't be happier. I see the same dentist I have been seeing for over 20 years. I trained him on what my needs were and he graciously accomodates me.

Thanks for the very thorough response, Gary! I think we just need to find a more competent general dentist. One of my biggest concerns with my husband's regular dentist is that he didn't fit Mike for fluoride trays, just gave him a Rx toothpaste and said to also use fluoride rinses and come back to see him at 6-month intervals. Seems like most people on the boards use trays and have more frequent check-ups. Your ideas and suggestions are much appreciated and will help us as we interview for a new dentist. Thank you!

Trimatt-I had my procedures done at UW. Their oncology dentist gave me the same info that Gary's did. I also didn't follow his advice and have all my teeth after almost 4 1/2 years! I'm on my 3rd dentist (Tacoma/Federal Way area) since our dental insurance plan keeps changing and I have to educate everyone of them on how I need my treatment scheduled. Be VERY proactive and follow the information that Gary provided. It works! Best wishes to you - Kris

Thanks, Kris. Glad to know you avoided total extractions! Sounds like the best advice is to be aggressively proactive, and we can certainly do that. Congrats on 4+ years of health! -Trish