I underwent surgery in aug 07 and radiotherapy Nov 07 for cancer of tongue and lymphnodes. I have had a long but successful recovery but now going for a simple filling of a tooth has left me quite scared.My dentist has told me my tooth is cracked,very infected and cannot now just be filled,it needs to be extracted.I telephoned my consultant and it seems quite complicated.other sources have told me that Radiotherapy damages the jaw bone,it can shatter if the tooth is not extracted correctly,can have complications with healing over,possibly getting infection in my jaw bone....list goes on.I will be seeing my consultant on 25th Feb for it to be reviewed but wondered if anyone else has had this happen to them?

Hi Sammy

I'm sorry to hear that after everything else, you now have a serious dental issue going on. I had three extractions done after my hemiglossectomy, but rt was not in my treatment plan. I'm sure that there's someone on the site who's been through the same situation and can help you through it. I really hope everything goes well. I'm surprised that there isn't a category of dentistry that deals specifically with the dental needs of people who've had rt.

Sorry I couldn't help.

Julia

hi sammy
sorry to hear about your dental problem.since rt i too am having problems and so far i have had 3 extractions.my dentist was not happy to take the teeth out and i was referred to the maxifacial unit which took several weeks to arrange and i was in so much pain.i spoke to my g.p just before christmas because again i was in awful pain with a toothache so he put me on very strong anti biotics and gave me tramadol for the pain until the tooth could be extracted.he said the situation as it was could not go on with me in agony and having to wait for a hospital appt,he told me to speak to my dentist again.i went to the dentist who said i still had a gum infection so more anti biotics were prescribed i asked her if she would do the extraction once the infection had cleared and thankfully she has agreed to do this.i know that after rt there is a nasty infection you can get that eats away at the jaw bone causing it to break down etc.sorry i cannot pronounce the name of this disease or even spell it but some one may see the post and tell you the proper name.my dentist also explained that due to the lack of saliva that infections get in the gums and in my case she said my teeth are very weak due to the lack of saliva.like you when all this was explained i nearly fainted from the shock.i think they are just being cautious and it makes sense to have your extraction done under controlled conditions,they may also give you anti biotics to take afterwards to keep any infections away.the best advice i can give you is the same as i was given at the hospital,keep your mouth very clean and brush teeth several times during the day especially after eating and also floss regularly too.hopefully you will not have a problem with the jaw bone.i really hope not.shirl xxx

Hi Sammy, I had exactly the same problem. I had to have a wisdom tooth out in hospital after surgery and RT. I dont know if it's the same in all cases but I had Hyperbaric Oxygen Therapy post op to help the healing process. Hagg.

Hi - my mum had exactly the same problem. The RT had damaged her teeth. She was able to have them out at the dentist but had to take some antibiotics before going, on each occasion. The teeth came out and the gums healed just fine.

Hi, this thread is very timely as my partner who finished radio therapy 12 weeks ago has been having pain in an upper molar and we were discussing it with his friend, who is a brilliant dentist at the weekend. She reckons it is an abcess and asked him to make an appointment. I was wondering whether he needs to be able to provide her with lots of information about his radiation field etc to enable her to make a decision as to whethre to refer him to a hospital or not for treatment. Is it only extractions that are an issue? How about other dental work like root canals and fillings?

Thanks
Cathy

Hello all ,interesting topic ,my hubby had teeth problems also for a while but was a year post treatment .He had pain in a back molar which I thought was an abscess ,our dentist was in full facts of Paul's treatment .On our visit dentist did x rays to check for infection and abscess their was no infection .He said that his treatment and dry mouth had caused the gums to shrink back a little and sealed round the gum of back tooth and others he thought were suspect .In the following months he lost one or two fillings they were replaced and all was well .
In the year following he had to have 2 crowns done due to abscess and theese were done without any problem his teeth are checked every 3 months by dentist and dental hygenist scales and polishes he also was a given a high fluoride prescription toothepaste to use at night only and seems to be working as so far all is well .I do believe in early stages post RT extraction needs to be dealt with carefully but usually dentists do not like to extract teeth that can be saved by doing a crown etc dentistry has come a long way and in most cases teeth can usally be saved .At moment Paul's teeth are intact due to 3 monthly dental appointments and dental hygiene care .he uses the biotene toothepaste and mouth wash plus high fluoride at night provided by dentist .At moment he has had a few fillings reinstated and 2 crowns in back teeth .

Hope this is of some help.

Bell .

Well thankyou thankyou to everyone who has replied.I was told this site was fantastic,I only wish i'd known about it sooner for support in those darker days. I've been back to my dentist today who's given me my xray to take to my consultant next week.He was still adament the tooth needs to be extracted as there's bone infection already-eek! I suppose being on morphine patches have probebly hidden the pain.I'll just have to wait until I've been to see my consultant,its going to be a long week.I'm really upset about it though as I've always been so careful with my oralcare,use biotene toothpaste,mouthwash,gel,brush and floss 3/4 times a day...I'm devasted to be honest.You think you're nearly there and back on the road to normality again and then you get another slap on the face!!I know its not the cancer again but it haunts you everyday.Sorry folks,feeling a bit sorry for myself x

To Cathy too,sorry forgot to add your reply.I would definitely mention everything to your dentist.Mine knew I'd had radiotherapy but he was just going to go ahead anyway with the exraction withiut referral.If I hadn't have just thought to ring my hospital,I dread to think what may have occurred.My consultant is at the moment checking where my RT field went to see if it is in that range.I'm going to ask if I have to have any dental work that I be referred to a speccialist in after cancercare.Its better to be safe than sorry I think now.

Well I've now been to see my conultant and not sure if its good news or not really.I will definitely have to have my tooth out but there could be lots of complications or it could go well with no problems depending on how I personally heal! I may have to go into an oxygen chamber every day for 6 weeks to supply extra oxygen to my jaw bone so that hopefully when the tooth is removed the jaw bone will heay over ok. If the jaw bone does not heal it may die off and then a graft will have to be done from my leg! there is of course a very low % that this could happen.He did say however that the tooth may just be removed without any of this,heal over nicely and that is that. I will find out next week what action will take place.Its going to be a long week waiting.At least the cancer has not come back but its going to haunt me for the rest of my life I think!!!! sorry just a bit fed up

One of the complications of radiotherapy is a condition called osteoradionecrosis (ORN).It is usual for head and neck patients to have a full dental check up before treatment starts so that any dental issues can be redressed.Many patients have multiple teeth removed as a precaution.Hyperbaric oxygen treatment can be prescribed if dental extraction has to be undertaken post tx,to reduce the risk of the development of ORN by helping the healing process.i am sure Dr Joshi will be able to give you more information,but try not to worry too much,its better to be safe than sorry.

liz

This message has been edited. Last edited by: cookey,

Hi Sammy, the hyperbaric may sound daunting but it isn't really that bad, especialy in comparison to everything else you have been through. I found it really boring but if it helps healing then it's got to be worth it. I had 6 weeks of it too and it did help a lot.
Try not to get too down. Things do get better as time goes on. Hagg.

Thanks for your replies.I'm feeling a lot more positive today.I've just got to keep thinking at least the cancer is not back so anything else is just a minor inconvenience. I think it got to me that I might have to 'waste' another six weeks of my life trecking up and down a motorway 100 mile round trip each day but then again it may not come to that.Roll on Wednesday-how sad I am wishing my life away and want to get back to Liverpool hospital quickly!ha ha! I'll keep you posted....

Hi! Sammy ,
That's what I like to hear , a possitive attitude and an exceptance to the neccesary. Unlike Hagg I haven't had htperbaric treatment but was informed of the need to have it if my teeth got any worse than they are, I have 1 tooth that is a little loose and the Orthodontist had warned me of the chances of the treatment and the reason why in the end I would have definitely had the treatmant as it was better than possibly having major reconstructive surgery if I hadn't had hyperbaric treatment, good luck with you ongoing checks and what a thrill it must be to be told that you are cancer free.
Love Trev

Good luck Sammy, I hope all goes ok and thanks for your advice a few weeks ago.

Best
Cathy