How do you care for teeth and dental health after H&N cancer?

My wife reminded me that I did have 2 molar crowns, a filling and I had a history of my wisdom teeth moving up and down. No others were extracted…I tend to forget things ever since my treatments.

MOJO

My husband had six teeth removed by an oncology dentist in an operating room since he also had congestive heart failure. Recovery was definitely painful but necessary. As of five days ago he is in acute pain again as a piece of tooth is working its way through his gum. My worry is infection or bone stress. He can’t get in to his own dentist for another five days but expects that he’ll just have to wait it out as the tooth fragment works it’s way out.

Hello @anonymous99,

Thank you for sharing your experience. I can understand your concern, especially with the long-term effects of radiation on dental health. It’s good to hear that your dentist has given you a positive report so far. From what I’ve read, radiation can indeed weaken the teeth and cause issues like root blackening, though it doesn’t happen to everyone. If no problems have surfaced in two years, that’s encouraging. As for Medicare, it typically doesn't cover dental care extensively, but there might be exceptions for treatments like Hyperbaric Oxygen Therapy if deemed medically necessary. It’s worth consulting with your healthcare provider to explore potential coverage options. Wishing you continued good health, and I hope you find a solution that works for you.

I generally passed my dental checkup with flying color but since my radiation I started to have all sorts of dental issues. Decay occurred under my bridge then one thing and the other. I did not associate the issues with radiation since I was not warned about that. Now that many years have passed, and happened to go to a new dentist due to a recent move. I was asked when did the bout of dental issues occurred, then it dawned on me that it was after my BC treatment. I decided to research on the topic and found many have similar experience. Now I would love to learn more about what can be done to remediate these challenges.

Hi @darapoza Thanks for joining in.
Dental issues after radiation are often caused by a combination of lower levels of saliva or just dry- mouth in general. Some have had tooth root damage or killed off due largely to radiation.
Then there are those like me, a select few who had the bone killed by the radiation, in my case the left mandible or lower jaw. This is known as Osteoradionecrosis or literally bone-radiation-death. When the mandible or a section there of dies, the blood supply stops and the tooth roots die.
Now normally with a common root canal, the tooth root is drilled out and filled with a cement. The tooth then is essentially dead but still functional because the base or bone is strong and holds the tooth firm. But if the bone is dead, it decays and the teeth fall out, like a tree with the soil removed.
Ah but don’t be discouraged, the bone can be rebuilt with a bone and tissue graph and a prosthetic teeth group installed. I eat corn on the cob easily.
Keep a watch on your teeth. An X-ray will show if your bone has deteriorated or if you get infections along the gum line can be a marker as well.
Likely it is dry-mouth which can be helped with rinses and possibly a drug such as Salagin (sp?) or similar.
Anyway, check out other opinions or enter dry mouth in the search box above for additional posts.
Me, I’m just one of many patients like you who experienced the gift of cancer.

Hi William,
Thank you so much for taking the time to share the information with me. I was totally in the dark and did not associate my teeth issues with radiation until I started to chart back when all the dental problems started. Now, with this awareness, I will pay much better attention to my dry mouth and dental challenges. Again, thank you!

Hi @darapoza,
I had 35 rounds (7weeks) of Photon radiation for a total of 70Gy and 3 rounds of cisplatin chemo for tonsil cancer back in 2008 but no surgery and to help with the brutal dry mouth tried electrical stimulation acupuncture in 2015 which was offered at my cancer clinic for head & neck cancer patients. I was tested to get a baseline and retested after 8-10 appts. and had great results. Never needed to go back and to this day 10 yrs later dry mouth is a non-issue. I also slept with a bottle of water next to me and got a Humidifier on my end table to make sure there was the most moisture possible in my bedroom to help get some sleep.

I got this from my other cancer group SPOHNC and it mention AQUAx2 which is a clinical research study for people with moderate/ severe dry mouth (xerostomia) caused by radiation therapy purpose is to assess the efficacy and safety of "gene transfer" study drug called AAV2-hAQP1.

In addition,I didn't have this available to me but others on this support group site have mentioned “Xylimelts Stick-On Melts” you can buy off Amazon and the box of 40 was less that 10 bucks. People say they really work, and they sleep through the night. And their daytime dryness is much better also. You should research using for extended period of time effects. Also, Biotene spray is effective long time after 2 or 3 sprays! And more recently there is a Aquoral Protective Oral Spray- Dry Mouth Relief which is more than temporary relief of dry mouth. Or a prescription of Cevimeline.

Hope this helps and you will get better. Good luck on the journey.

Thank you so much for the information. I will check out acupuncture with the hope that it will be less long-term maintenance. I will try the products you mentioned as well. Went to Target and found a Biotene mouthwash. Again, really appreciate your response. Thank you.

Xylimelts are the best! I too have tried many products for dry mouth (I'm 8 months post tonsil treatment 35 radiation & 6 chemo) I find most help very little if at all EXCEPT for Xylimelts! These things really work, I use just one tablet every night and they definitely have made a big difference. Best of luck to you!

I have stepped up my game in the four years since I was treated:
1) see dentist 3 times a year
2) use prescription fluoride toothpaste, brushing 4 times a day with an electric toothbrush,
3) follow twice a day and use a water pik daily
4) Use dental trays at night with a fluoride gel.

Hope that helps. Good luck