Laura
are they giving you general anaesthetic for removing two molars? Seems a bit extreme to me, unless your jaw opening is really limited.

I have a relative that's an oral surgeon, and he extracted a tooth for me with a local when I could barely open my mouth wide enough to insert a finger. He did freeze the hinge points of my jaw as a precaution, but general anaesthetic is inherently dangerous to being with. The anaesthesiologist is definetely repeating what the lawyers have told him to; all those things can happen.

I know I would be VERY upset to wake up with a front tooth broken off by a canula during the process, or a trach (already had one of those)from ecessive swelling. I think I would be really questioning whether or not surgery of this extent is REALLY necessary to begin with, especially if your teeth are in great shape.
Wayne

Well,I felt like I needed to get a second opinion on whether or not to pull my two molars in that area. So, I called the original oral surgeon I had seen when my tumor was discovered/diagnosed. He said he would not recommend that those teeth be removed, that they were healthy and that my gums were healthy as well. I think this has left me feeling even more confused as to what to do.

I also asked him about the pathology report on the tumor. The original pathology report from my biopsy diagnosed the tumor as a low to intermediate grade adenocarcinoma of the salivary gland with mucoid epidermal like features. The military labs (all slides and info were sent to another military lab on the east coast for confirmation) diagnosed it as low to intermediate grade mucoid epidermal carcinoma of the salivary gland..... I asked the ent about this and he said pathologists could argue for hours about which type it is. He said the important factor is as to what stage it is in. It was slightly over 2 cm but the nerve tissue within the tumor graded it as a T2NOMO. The original oral surgeon questioned from the beginning as to whether or not the lingual nerve was involved or not, Ive asked the ent as to whether or not that was removed. He said the pathology reports would tell us. Im assuming it was, although I dont know for sure. The oral surgeon asked if my tongue was numb on that side of my mouth and I told him it was , he said that they probably removed that nerve then. It doesnt surprise me , Im just wondering why the ent didnt explain this to me.

As far as the general anesthesia goes, I requested to be *out* for the extractions because I have limited mobility with my jaw. The muscle is very tight on my right side since they removed some of my parotid muscle to the jaw...(what opens and closes your jaw). I wish I knew without a doubt as to what to do. Im uneasy removing healthy teeth, at the same time, I do believe in listening to your doctor's when they recommend things. Im pretty comfortable with going with the radiation rather than not doing it and just watching things. I wasn't happy about the recommendation, but I was leaning towards doing it no matter what for the possible extra insurance to keep the cancer away. But, like Ive said, I dont know what the right answer is to pulling my teeth as preventive medicine.

Laura,

I was treated at Wilford Hall in San Antonio Tx. It is the big Air Force treatment facility and they didn't recommend I have any teeth out. They fixed a couple of fillings and made me some thick dental guards to where during radiation.

There is no right answer here for you. You must decide what you are most comfortable with and then go with it.

Time for a third opinion. I had XRT and foolishly let them pull my 16 rear teeth without getting a second opinion. When my periodontist and MD Anderson trained prosthodontist saw my xrays, they said there was no reason to pull the teeth. They did have fillings but were otherwise healthy. I was told that if I didn't have them pulled, I would need 30 hyperbaric oxygen treatments if I ever needed a root canal. While my 12 remaining teeth have decayed due to restricted saliva despite religious dental care, roots are solid and they have been capped.

How many H&N cancer patients do these doctors see in a year. I get a third opinion from someone who specializes in H&N cancers at a CCC center.

Take care,
Eileen

I've read some of the other comments, but in my case it was different. When I originally went to the Rad doc, I was told I should have my top teeth removed. I didn't listen. Now 1 and a half month after completing treatment, I cannot use my teeth and I cant have them removed either, because of a risk of a (unknown to me) disease. Three doctors, after I requested to have my teeth removed, advised me of this disease. They said it would be like gangreen (sp?) in the mouth.

The gums would decay and there would be no blood supply to that area, its painful and there is no cure. The hyber-something tank is not medically proven to work from what I researhed on the net. So if I could do it one more time, I'd have my teeth pulled. For one, you can get partials, or dentures or something to replace the teeth. Its not like you'll be without teeth forever. Not to mention if you're wrong by not removing them, what will the outcome be?

I'd weigh the advantages verses the disadvantages, the safety verses the unsafeness, and then make a decision. There is an old saying
"Better safe, than sorry"
Hope you make the right decision for YOU.

Hi Cooldown,
I said you shouldn't have HEALTHY teeth pulled and to seek a 3rd opinion.

Why can't you use your teeth? You didn't say. It sounds like the condition is permanent, but what is it? Have they decayed? Can they be reconstructed? Or do you have gums problems or both?

The name of the game as always is to take meticulous care of your teeth during and after radiation treatment. Besides the floride trays, my periodontist cleaned my teeth every 2 weeks during treatment and the dentist and the dental surgeon took care of bone chips that came through the gum that was trying to heal from a biopsy. I brushed regularly and took Salagen to help with saliva.

The hyberbaric treatments are meant to restore the blood supply to the bone. The condition you are talking about is probably osteoradionecrosis which is basically bone dying. And I was wrong in previous post, you don't need it for root canal(although the dr that had my teeth pulled said so), but you do for pulling teeth.

I don't know where you are being treated, but I would see a dentist that specializes in cancer patients to see what can be done. Caps might be a possibility if root are good.

Take care,
Eileen

Hi cooldown, I also think the condition you are referring to is osteoradonecrosis(thank you Eileen). There was a recent post by Lenny that touches on this and I think Lenny states that it only occurs in about 5% of patients.I think it is more of a long term complication from radiation. I also have had several teeth pulled and many root canals without Hyperbaric oxygen.I don't know what specific complication you have with your teeth but maybe you can let us know what your condition is called for us to be more helpful.Pulling healthy teeth I don't recommend, but you must deal with dental issues forever and sometimes for the better of all a few must go.