Hi, I have had to have a couple of fillings on the upper left side of my mouth, and as this did not cure the pain I was suffering I was given antibiotics just before christmas for a abcess under another tooth. This removed the pain so that thankfully this year I was able to enjoy my Christmas dinner. After Christmas I had a root filling at great expense, and a little pain. My dentist told ne that he thought he had an 85-90% chance of saving the tooth, so I thought it was worth it. I had radiation to the right side of my neck for tonsil cancer, and I don't have many salivary glands left on the right side so I only eat using the left side of my mouth. My dentist has told me that teeth can be brittle after a root filling and her may want to crown the tooth in six months. Three days after the root filling the back of the tooth has broken off, and I am going to the dentist this afternoon. I am worried that he may not be able to mend the tooth, and may recommend an extraction. However I have heard that extractions can be tricky for people who have had radiation therapy to their jaw, as the jawbone can die in the trauma. Can anybody advice me on this issue.
I'm using the biotene antibacterial toothpaste, but reading the ingredients this doesn't seem to contain fluoride, does anyone know if you can use anything else to apply the fluoride to your teeth
Original Post
Hi Rose,
Thankfully my dentist was able to repair my tooth, and the breakage has not compromised the root filling, so I will not need to have the tooth removed. He also read the ingredients on my biotene toothpaste and spotted the fluoride which was listed as its chemical compound. He didn't think that I would still have problems if I needed an extraction, but if it does come to that I will make sure I discuss it with the radiology oncologist first. I took some documentation I found on the net about the possible complications of radiology and he read through them and said that I was probably past the stage where we needed to worry about most of the side effects. He is a very good dentist and I trust him, but the side effects of radiation therapy and the effect on future dental work are probably a specialist subject. I think I frightened myself by researching the subject on the net, and I found some scary photos of bone necro...something or other, after a tooth extraction.
Hello Jenni

If the cancer was away from the area of the tooth to be extracted, it will likely not be in the field of irradiation and hence no risk of osteoradionecrosis (ORN). Also the maxillary (upper teeth are at less risk as the blood supply in the maxilla is better than in the mandible (lower jaw). But check with your oncologist about the radiation field so that you and you dentist know which extractions pose a risk.

Please read this previous discussion on care of the teeth.

Best wishes
Vinod Coffee
Hi Guys

Just to add my experiences. The hospital dentist that I had to see before going through the treatment made me a tooth shield and advised me to use Oral-B STOP gel (which I sometimes have to get from the US on the internet) It seems to work well and my normal dentist is surprised that she doesn't have to clean the plaque anymore - plus I think my teeth are whiter than they were. The only pain is that it takes longer to get ready for bed these days as the gel "bath" takes about 15 minutes.

Thanks for the advice Dr Joshi. I think I'll increase my dental care regime, as I had returned to just brushing twice a day. As I have had too have three fillings it doesn't look as if I'm taking proper care of my teeth. I will also get some of the interdental and interspace brushes and the fluoride mouthwash.
Jenni, I use duraphat 5000 which I get on prescription. It is a very high concentrated flouride toothpaste my dentist recommended it. You can use it as a normal toothpaste and at night smear a tiny bit over gums and teeth so the flouride is absorbed during the night. I also use a flouride mouthwash every day also on prescription. Even after all this care I have noticed my gums are receeding and are really sensitive. Fortunately by best friend is a dentist!
There is also duraphat 2000 which is not as strong but your gp might prescribe it easier for you.

Take care

SmilerHappy New Year to you all.
I had a dental appiontment today, and last night I did a check on the gums, and on the left side on the root of my canine tooth there is a round hard ball, it seems fixed and very hard, no pain; I had most of the rad treatment on the other side, so I am wonder what it could be; would Doc Joshi have an idea ? The dentist has taken a xray.Big Bear Healing Hugs to you all
jenni, i too have had radiotherapy for tonsil cancer and have two bad teeth in the same area. you need to get to a dental hospital as well as an oncologist. let the specialists deicide. this is not an area for the local dentist. In my case the dental hospital decided to leave the teeth in and prescribed Duraphat 5000. they review the situation on a regular basis
Hello Guys if you face the problem of tooth then you should Swish often with salt-water, or just get some medications until the disease is gone. Sodium normal water will strengthen it up.
Hello Brown4
What is the basis for your advice to mouth cancer patients to rinse the mouth with salt water to prevent tooth decay?
Regards, Vinod Coffee

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