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

Posted by anonymous99 @anonymous99, Feb 16, 2022

Hi there. I am ten years out from base of the tongue and throat cancer. I have been filling my teeth for all these years but now some of my teeth are starting to fail. I met with a local oral surgeon who recommended the oxygen therapy and then to continue to pull the problem teeth with dentures being the only long term option for me. I’m wondering if anyone has had similar experiences or have been provided with alternative options. Thanks!

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Hello@anonymous99, This is something I have been wondering about, as I finished radiation for throat cancer two years ago. The dentist told me my teeth look good, (and to use alot of fluoride daily) although if and when they fail, it begins with the roots turning black. A nurse related that in her opinion, if no blackness has begun in two years time, my teeth should be fine. Can you say for sure after ten years that it is the radiation that is causing your teeth to fail now? My fear is that in a few years (God-willing) I will go on Medicare. The insurance I have now has good dental, but Medicare goes only so far. Would that even cover Hyperbaric chambers, as the cost would be enormous. Thank-you, for any answer you can give.

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when I went through throat radiation 7 years ago my dentist made me some trays for my teeth. I put a fluoride gel on them and keep them in my mouth for an hour. I do that every 3-4 days and will continue forever. so far so good… Good luck!

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Hi, I just completed 5 yrs of being cancer free from base of tongue cancer. Other than the obvious effects of radiation on my throat, tooth loss
was my other long term effect from high dose radiation. That being said, all but 2 of my lower teeth have finally been removed and I was just fitted for a complete partial. The 2 remaining teeth serve as an anchor point I am so happy with my denture and can finally bite down and chew some foods. My surgeon and dentist said this was my only option if I ever wanted to eat certain foods plus I can finally smile:) Good Luck on finding something that
works for you!

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@sammy15

when I went through throat radiation 7 years ago my dentist made me some trays for my teeth. I put a fluoride gel on them and keep them in my mouth for an hour. I do that every 3-4 days and will continue forever. so far so good… Good luck!

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Dear @sammy15, Wow! That sounds great! Thanks!

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@thomason

Dear @sammy15, Wow! That sounds great! Thanks!

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you're welcome, hope it helps!

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You may want to find out if the jaw bone has died, which supports the teeth. This is known as osteoradionecrosis or ORN. Not to alarm you but cancer is the gift that keeps on giving as we say. ORN is treatable as I can attest to. Without treatment, the mandible (jaw bone) being dead from radiation will deteriorate to the point of breakage. At that point it becomes an emergency and of course rather painful.
I am not a doctor but I am a patient. Tonsil cancer, radiation, later teeth issues, antibiotics and infections, loss of teeth. Eventually x-rays showed my mandible to be about half normal density and rotting. However the fine folks at Mayo were able to put Humpty-Dumpty back together again and today I am enjoying a fine life sans issues.
It wasn't a pleasant experience, no surgery is. But it does work and many have had it done. It is known as "Fibular free flap reconstruction following segmental mandibular resection", or just plain jaw replacement. This is only done (or done well) in about four places in the US, one in the UK, and a few other places around the world.
Probably time to go from the dentist to oral surgeon or medical doctor for an evaluation. Not addressing this is not a good option. And you will have a couple of really neat scars at the beach next summer which is a plus.

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You guys may also appreciate reading this related discussion:
– Teeth and Head & Neck Cancer https://connect.mayoclinic.org/discussion/teeth-1/

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