With having a tooth crowned, are there any special issues for post radiation patients?

Nope!

Only problems when having extractions or deep gum work done.

Thanks, Christine, for this and all the other times you helped me.

You're welcome, Andrew! Thats what Im here for.

Hi Andrew,
I've had a couple of crowns and even had a root canal 2 months ago.

No problems or special concerns.

While its not fun, after what you've probably been through with cancer, its no biggie.

As a general precaution I always like to let any new medical team know my oral cancer and radiation history and that I've been cautioned to never have teeth extracted!

I have seven remaining teeth. All bottom front. All of them have had a root canal and all of them have been crowned. My dentist openly worries about his ability to maintain even one of them for another day, but so far, so good and I will take it. There is nothing like 62 radiation treatments to knock the stuffing out of your teeth! Hang in there.

I'm beginning to wonder about my dentist. I don't expect him to be an oral cancer expert, but I do wish he would take what I tell him more seriously. Or at least be able to have a conversation with me. I tried refresh his memory on why my jaw is at risk, and explained that the blood supply is reduced in the jaw bone, which means the body can't mount a normal immune response there. His replay was "No, I saw blood come out of your gum when I was working. Well, I never said there was no blood in the gum. I also told him that my followups with doctors are primarily to check for delayed problems caused by radiation. He said "No, I'm sure they are checking for other things."

And it's not just cancer-related. He told me that if the floss gets stuck to just pull it out the side. I started to explain that the floss I use won't allow that, and he jumped in and started explaining to me that there is only one kind of floss. Except this time I was not speechless, and I told him I use Glide floss which is attached to a wishbone holder. At which point he offered me a sample of regular floss, which is where I was going in the first place.

I don't know what his deal is, but conversation with him seems to be him wanting to find a reason to disagree with me, for reasons I don't understand. He didn't use to be like this, or maybe there was just nothing that came up to disagree on.

Sounds to me like its time for a new dentist, someone who is more knowledgeable and less argumentative. Its scary thinking how some dentists are so uninformed!!! That kind of dentist could do serious harm to their patients (like OC survivors) who require extra care. Its a darn shame your dentist isnt more open to hearing about new products. Dental floss has had other options for years. Nobody knows everything but as a professional they need be more proactive with their continuing education. Your dentist might want to also be more open minded, that is if they plan on keeping their patients for long term.

[quote=ChristineB] Dental floss has had other options for years.[/quote]
I forgot to mention that he's the one who first told me about Glide, years before this. He even gave me a sample. So he knows this exists, but he launched into argumentation mode anyway.

Is there a dental oncology department at your original treatment facility? If so, can you make an appointment there to have your teeth checked by one of the dentists there? They are likely seeing cancer patients every day.

One more thing. Shortly after the crown was put on and I started feeling pain in the area around the root of that tooth.. It persisted. And it was scary, because having an infection there is very risky

My periodontist told me to swab the area with Peridex (Chlorhexidine Gluconate). I did that for a few weeks and it worked. But after I stopped the pain came back. So I started swabbing again, but for many weeks. When I stopped the pain never came back, I wish I could tell you how many weeks, but I didn't keep track. .

It is not uncommon for the gingiva around a new crown to be sore for a period of time. The soft tissue can be damaged during the tooth preparation by the burr in the handpiece, and the tissue is packed with a thick cord to push and hold it away from the tooth, so that the margin where the crown and tooth ultimately meet is fully exposed for the impression making. The lab tech will need to see that margin in detail on the model of it made from the impression to fabricate a crown that will fit perfectly and intimately to the prepared tooth. It can take a week or more for that periodontal gingiva to tighten up around the neck of the tooth again. Even when the new crown is seated, the process of cementing it in place, then scraping any extra dried cement from that soft tissue sulcus around the tooth can irritate it again.

Keeping it clean is important even though brushing it can be irritating, and further prolong the discomfort. The Peridex is a useful tool to keeping bacteria at bay in this area till the healing is completed. Sounds like it all resolved.