Hey Vet613, You are definitely in the right place on this. Expect a response from Greg on this. He's a member of the WhatNext Team and has a lot of experience on this as he received radiation for Neck/Throat Cancer. He, like you, has had some dental issues.
Head & Neck/Throat Cancer Questions
Dental issues after chemo & radiation for SCC on base of tongue
Asked by vet613 on Monday, November 19, 2012
Dental issues after chemo & radiation for SCC on base of tongue
I hope to leard from others who have faced dental problems involving extraction after radiaton treatment.
10 Answers from the Community
Hi Vet, yes I have extensive experience in this matter. Currently on a plan to have all teeth surgically removed. I have been told and educated about the problems with Osteoradionecrosis possibly setting in, and talked to all forms of specialists.
What sort of questions do you have?
Thanks for your fast response to my question. I have been told that because of the extensive restoration work I have had that my dental issues can only be fixed by fitting dentures.
The oral surgeon (from the VA hospital that I was treated in) proposed extracting all of my teeth and three implants I have. The concern is the radiation I received during treatment puts me in danger of having osteonecrosis. The Dr. spoke of thirty 90 minute sessions before the surgery and 10 after. This is supposed to increase blood flow to the affected area. Does that sound "normal" and what are the chances of success with that kind of treatment? Also are there negative side effects?
Mr. Vet. First, thanks for your service. My father went to the VA Hospital in Nashville for 39 years before he passed away. I made many trips to take him there.
Your doctor is telling you exactly what I have been told for a couple years. The HBO treatments, (hyperbaric oxygen) are needed to infuse rich oxygen into the body to encourage healing. The problem is they expect those of us that have gotten radiation to the jawbone to get Osteoradionecrosis. It doesn't mean we will get it for sure, just a high probability. I was toldto get the same treatments 20 before and 10 after. Cost of $48K. My insurance will not cover, and I cannot afford. So I told my Doctor, we had to do something else.
They started cutting out my teeth 2 at a time to watch how they heal. So far so good, and I haven't had the HBO treatments. I had 2 cut out 3 weeks ago, and go back this wed. to see how they are healing. From what I see so far, I think we will be taking the rest out.
If your insurance will cover it, go for the treatments. The doctors all but refused to take out my teeth without it, and I've looked up a lot of information on Osteoradionecrosis. It's not a pretty thing. But I had mostly no choice. So I'm going for it.
Best of luck to you, let us know how things are going for your, and thanks for being here at WhatNext.
I too had SCC base of tongue, left side. I had all my lower molars (both sides) prophylactically removed prior to starting my chemo and radiation treatments. It was, and continues to be, extremely inconvenient as I am unable to chew (masticate) any large pieces of food. After my treatments finished, I was feeling quite well until a tiny (and sharp!) portion of my lower jaw (mandible) bone began to protrude from one of the extraction sites as the gum receded, and was irritating the underside of my tongue. As I had completed all my radiation, any oral surgery had to be preceded by a LONG series of HBO (hyberbaric oxygen) treatments to rejuvenate the capillaries in jawbone. This was done, oral surgery successfully completed, and post-surgery HBO finished. I feel great and, if the biopsy results for site of the former tumor come back negative, I will intensify my workouts the try to regain some of my upper body mass and strength. I am now awaiting the completion of a set of partial dentures for my lower jaw. It will be soooo good to chew into a chunk of prime rib once again! Patience and taking it all in one day at a time has helped me and my spouse deal with this interuption of our lives as active retirees.
Please, please go to an oral surgeon to have any teeth pulled. I had a tooth pulled after radiation and chemo and now I have osteoradionucrosis of the jaw bone. It is quite painful and I go to the oral surgeon to clean out the bone around the extracted area. My tongue is very painful as is my whole mouth. I finished chemo & radiation one year ago and still facing lots of problems in my mouth.
My thanks to EVERRYONE,
I wanted to take a bit of time to thank EVERYONE who has posted a response to my HBO questions. Words to describe my appreciation all sound trite and meaningless to me. Your collective responses have been great and I cannot thank you all enough.
I am scheduled for another dental consult in early December and will make my final decision then. I believe, however, that my decision has been made for me due to my need to have chewing surfaces. Even though my teeth (as the old joke goes) will be like the stars...they come out at night (LOL). I have already endured worse experiences, from spending close to two years recuperating after being WIA in Vietnam in various military hospitals, to the Chemo, radiation, and waiting for results from my latest medical drama.
Again I truly thank all of you for your sharing and concern.
My vesr best to you & yours,
Good day GregP,
When I am in a "good frame of mind," which is in my case realistically is not every day I call my little dark companion that is cancer "the gift that keeps on giving" it seems to always be delivering a new surprise. this Friday I will pick up my hearing aids to help with the hearing damage from my Cisplatin treatments (and I suppose that my 35 "tanning sessions") contributed in some way also. I do my best to remain positive and I find a sense of understanding and fellowship on this site that helps a lot.
Greg when I read your numerous posts, and those of others, I get encouragement I do not find elsewhere. I find the challenges faced by many members give me strength in the courage they demonstrate. I feel fortunate to have found this site and will post the changes in my dental situation. My continued research into the HBO pre & post extraction to be encouraging and have another dental consult scheduled for early December...I hope to make my decision shortly thereafter.
Thank you for your continued interest and encouragement,