My husband has finished his radiation treatments and is wanting to see about getting some teeth. He had six of his lower front treat removed when they did his surgery. The ENT Dr. said he would not suggest implants. My husband agrees and is thinking dentures. What type of dentist do we need to go to? We didn't think just our regular dentist would be the one but we are unsure as to where to go? Anybody out there have any experience with this we would love to hear and get some advice as to what our step should be.
Thank you.
Rhonda

Hi Rhonda,

He can see a general dentist that does dentures or a specialist, called a prosthodontist. A prosthodontist is a dentist that has gone to school for additional training in making dentures as well as bridges, crowns and implant related treatment.

Before making an appointment it would be wise to ask if the dentist or prosthodontist has experience in treating post radiation oral cancer patients.

The yellow pages usually has listings for specialists in the dental profession, if you feel that you want to find a prosthodontist.

Jerry

Rhonda....I'll bet that Jerry knew that I would chime in here. Jerry's opinion is always very on-target, since he himself is an obviously compassionate dentist, and obviously made more insightful by his own cancer experience.

My surgery involved removal of part of my maxilla (upper jawbone), with the accompanying teeth, of course. I must wear an appliance called an obturator, since this surgery left an opening in my hard palate.....the roof of my mouth. This appliance was made...and continues to be adjusted....by a prosthodontist.

Here is my advice: Find out from the Head and Neck surgery department of your closest Comprehensive Cancer Center.....Wash. U, perhaps....and ask for their recommendation. They will surely have a prosthodontist on their staff, and if they do, I would go to him/her.If not, ask who in town works with the head and neck surgeons. The one who will know is the NURSE. If you don't get satisfaction from the desk, ask politely to speak with the surgeon's nurse.

My prosthodontist works closely with my surgeon. He also does general work, including dentures and crowns, but he is familiar with cancer and with surgical problems. Most prosthodontists in general practice make lovely dentures and beautiful smiles with veneers and crowns, but will likely not have experience with the problems related to cancer, surgery, and radiation.

Hello Rhonda

Maybe you can help me with a question? I had full lower dentures, which still fit. On top I only had 4 teeth that my partial clipped to. These 4 teeth were extracted during surgery, thereby making my top bridge useless.

The MO & RO said to wait until after radiation to get the dentures. My rad Tx does not start for 3 more weeks. I was thinking of getting just a top full denture ($300/made overnight/throw away) so at least I could chew for possibly 6 weeks.

They are saying my gums and jaw bone will shrink during IMRI. I'm thinking it would be worth getting the 1 top denture just to eat for the 6 weeks and besides appeaseing me, it would keep my jaw muscles from atrophy.

So my long story short question is, how much did your gums shrink, if any. Can you tell if they did. My tongue feels 90% healed and my mouth and jaw muscles are fine.

My lowers are implant dentures and I was just about to have the posts put into the jaw bones. ($4,500)

Did they not recomend the implants because the bone will not except the implant studs after rad tx? I know I'm all over the board here and ping-ponging my thoughts.

An apple may be out of the question but just to bite and chew a hot dog, a soft sandwich, spagetti, egg foo young...fried chicken, crab cakes mmmmmmmm. I want to eat!

Thank You. Petey

Ronda,

All the advice you have been given is good. In my case, the radiation oncologist recommended a dentist who deals with post-rad patients. I have been exceptionally pleased with what he has done for me.

Had that not worked out, I had planned to call the Dental School to see which of their alumni were dealing with patients like me.

I would ask the ENT why he does not recommend implants. I had a full load of rad, but am extremely happy with the implants. Not as good as real teeth, but a good substitute. It seems to me that a qualified dentist would be a better judge of that situation, so do not rule them out.

In any event, I was told that nothing could be done until six months post treatment, giving the radiated tissue time to recover. It is, however, not too soon to line up a dentist and talk to him/her about options.

Good luck! It may seem like a hassle to get new teeth, but after what you and your husband have been through, it will be a cake walk.

I apologize, RHONDA. Typing too fast, proofreading not too carefully. I really do try not to misspell names.

Rhonda & Petey,

The concern about placing implants after radiation is that there may have been some damage to the bone and the blood vessels in the bone, called ORN (osteoradionecrosis). This does not make it impossible to have implants done. HBO (hyperbaric oxygen) treatments can help to make implant placement possible.

Do a search on the forum for both ORN and HBO. These topics have been discussed many times here. A google search on the web will also give a great deal of information.

Petey, throw away dentures, as you call them, could possibly be "throw away money". For $300,
I wouldn't expect much success with eating.

Jerry

Jerry,
For future planning...does your office do these implants?