The prosthodontist I am seeing as part of the cancer care team told me that my dentist should not use an ultrasonic scaler or do any manual scaling more than 2mm down. I asked him about the problems from plaque building up below to 2mm. He really put a scare in me, and said that if a dentist does lower it could result in my loosing my jaw. I assume this would be from infection. But I just spoke with an oral cancer survivor on the other coast who was told that deep scaling is important because periodontal disease is more dangerous for people like us, and scaling helps prevent this.

So now I'm very confused and worried.

I'd like to know what you were told about having your teeth scaled, and how deep they can be scaled. And/or any thoughts you have about the information I was given.

Well I would like to hear exactly his reasons for advising against it.

I was never advised like that and I haven't heard anyone else say they were and I have had my teeth cleaned twice a year as always since my Tx ended. I did start using the fluoride trays 1 month pre Tx and have used them every nite since.

Jerry, comments?

Where's Dr Mike anyway?

Andrew, that is an interesting comment. I have been getting standard cleanings every 4 to 6 months for 8 years. I have never heard this. It would be interesting to know if this is her/his own opinion or something new in the field. I too would assume it to be out of concern for infection and then Osteoradionecrosis ORN which might follow the infection.

Would you be able to ask this prosthodontist for more detail and references to any study?

Hmmn. My prothodonist who specializes in head and neck cancer after specific training at Sidney Kimmel CCC has only done regular cleanings with his ultrasound. But I don't know how deep he went. Let us know what you find out so I can see what he thinks. I love his panoramic X ray- no sharp cardboard squares to poke my tender mouth, even if I could open wide enough right now. It was fun to see my titanium plate with screws holding the front of my jaw together

[quote=davidcpa]Well I would like to hear exactly his reasons for advising against it.[/quote]He had told me previously that the radiation destroys blood vessels that supply the mouth, and so the body has a lot of trouble fighting infection there. He also said that if an infection starts, it is very difficult to deal with, and can lead to serious problems. When I found out that he told my dentist not to clean below 2mm, we just assumed that he said this because scaling there could lead to infection. And later when he said I could destroy my jaw, I assumed it was the infection.

What I'd like to do is hear from as many others as possible who had radiation and then talk to him about what other doctors are recommending. Because from what I know, built up scale can lead to periodontal disease, bone problems, and even bleeding.

I've been getting my teeth cleaned every 2-3 months for the past year. I go to a prothodonist who treats a lot of the cancer patients in the area. He does have me take an antibiotic 1 hour before any cleaning or other dental procedure. I do have some loose teeth due to bone degeneration from the RT. I have been using chlorhexidine 0.12% oral rinse daily for the past few years because of post-treatment issues. This does cause staining of the teeth which is one of the reasons I go for frequent cleanings.

Geez. My periodontist scaled my teeth every two weeks during radiation and has been cleaning/scaling them every two months since for the last 12 years. Maybe the reason they clean mine so often is so they won't have to go so deep. I'll have ask.

Take care,
Eileen

Well,
Hi all...here is my two cents worth.
There are no known contraindications to scaling and/or root planing in conjunction with chemo or radiation therapy. Mechanical removal of calcified deposits on teeth and tooth roots do not interfere with cancer therapy.
There is as well no indication that cleanings with sonic, ultrasonic, infrared or other types of cleaning are detrimental to patients who are undergoing chemo and/or radiation therapy.

Dr Mike,

What about post radiation Tx?

Hi. Thanks for jumping in. I am post-treatment, and the prosthodontist is not saying that scaling will interfere with cancer therapy. His concern is that because of the reduced blood supply to the jaw bone, scaling below 2mm creates a risk of infection that outweighs the benefits of scaling beyond 2mm.

[quote=Dr. Mike]There are no known contraindications to scaling and/or root planing in conjunction with chemo or radiation therapy. Mechanical removal of calcified deposits on teeth and tooth roots do not interfere with cancer therapy.
There is as well no indication that cleanings with sonic, ultrasonic, infrared or other types of cleaning are detrimental to patients who are undergoing chemo and/or radiation therapy. [/quote]