Actonel, et al not the only dental risk.....radiation is too!!

Cathya · 01-09-2008, 03:31 AM

Darita;

The dental surgeon I spoke to told me that my risk of osteoradionecrosis was higher in his view than the risk of the other from actonel. He told me that the tooth must come out and it is merely a question of what I am prepared to go through prior to that. I have had two opinions on the tooth removal unfortunately...and it does need to come out...there is an 8 mm pocket which seems to have come up suddenly. He did the x-ray that wraps around the mouth and told me that there is no way he can tell if there is damage to the bone area of the tooth prior to its removal. The radiation was on the other side of the mouth as the clavicular node is on the left side and the tooth is back, bottom right but I did suffer blown teeth on both sides although more on the left. It is so frustrating. He told me that I would get antibiotics following the tooth removal and that I would know within two weeks if there was going to be a problem. Basically it sounds like a crap game.....pull the tooth, hope for the best. He discussed the oxygen chamber but didn't seem too keen. I question that as I have had this little lacunar stroke and don't want to fool around with pressure on my brain....this is just me deciding that intuitively so I could be totally wrong. He also said that there was no way to prepare for the tooth removal in order to reduce the risk. Well....like I said....a crap shoot. I would so appreciate any ideas you might have. Thanks so much.

Cathy

TriciaK · 01-09-2008, 10:07 AM

I am very interested in this thread as I too have a tooth which really needs to be extracted. It is the last tooth on the lower right side---may even be a wisdom tooth as there is no jawbone beyond it. I only had zometa about five times---does it matter how long? I have not had radiation. What kind of a dental specialist should be consulted? My regular dentist won't touch it. What is the hyperbaric treatment and what is it like? I appreciate your info and experiences--as always this site seems to be the best place to get answers! Thank you all so much---Hugs, Tricia

Cathya · 01-09-2008, 11:33 AM

Tricia;

The dental surgeon I saw said that the half life of these biophosponates is very long so I would think you would still have to consider that a risk. However, he did indicate that he felt the risk from radiation was more than from these drugs. He thinks the risk is there but not a large one. Thank goodness you didn't have radiation. Hopefully someone will have more information.

Cathy

dchips1 · 01-09-2008, 11:35 AM

It is interesting how no one seems to know much about the osteo or osteoradionecrosis, (medical people) . The biggest thing was for me to keep caling and asking around town, not alot of docs/dentist have dealt with it. My scrape to the lower inside of my gums progressed (04/07 initial injury) to in 9/07 I had huge peridontal pockets (they say) to where you could just flap back gum tissue off the 2-3 back molars . At first they thought it was an abcess, because it was a white pimple area, no pus would come out then the white would go away and the gum could be flapped away. I did have a lot of pain under my jaw and you could feel a lump under my jaw and they would put me on antibiotics to calm down the outside. The hyperbaric oxygen was done at a hospital they have 2 chambers which are individual chambers. this allows for customizing and I like better then a group chamber, I did 20 "dives" slept most of the time or watched movies, within the first 2 weeks my mouth started to heal, this 5months since it started, I had tried almost anything and now I have had even another root canal then 10 more dives, my teeth cleaned and not alot of pain except for my TMJ joints, because my teeth have all shifted, and I clinch them at night. I was told if anymore dental procedures then you do 10 follow up dives. They have seen people with extractions heal up after O2 dives. As far as the stroke hx the medically eval you before you go in, they actually reccomend it post WBR rads and also use for Cerebral palsy. I went to Chandler Regional Medical center in Chandler, Az the tech there is DAN he was a "jaw" saver, he answered all my questions and reffered me to web sites, because everyone I talked too hadn't really messed with hyberbarics, nor thought it would help, but I pursued it and the insurance company paid for it because of the "radio" radiation component of the osteonecrosis. Medicare will pay for it with radiation hx. Sorry so long and scattered but ask anything if I have forgotten . Darita

dchips1 · 01-09-2008, 11:42 AM

MRI, and panogramic x-rays did not show anything when my jaw was at it's worst. They say there is not a definitive test to dx this, but it is more based on symptoms and the bone exposing itself and dying. Interestingly my last 3 PET/CT scans showed NED in body but blew pretty high uptake in the jaw everytime. HMMMM you can googlepictures of osteonecrosis some are pretty gruesome. I will try to find the web sites of hyperbarics and osteo

Cathya · 01-09-2008, 11:46 AM

Darita;

Would you suggest that I set up this oxygen chamber as a preventative messure or wait and use it only if I had problems?

Cathy

dchips1 · 01-09-2008, 11:57 AM

Cathy, it is as you called it a crap shoot, the tech that I worked with have seen alot of people do good with pre/post treatment dives. I swear by it. Because of how bad mine had got, yeah I had two root canals since radiation but my teeth are in my head, and my clear braces anre cool!! (says my 7 year old) I would cry all the time thinking I was going to loose my teeth and jaw, I still worry now but not as much because I do not have the big open deep pockets. So if I was in your shoes I would talk to your local center. Chambers are located all over the place, and getting your ins to pay can be tricky but call a wound center near you and see who has a chameber and ask them to help you thru the Insurance auth mess.

dchips1 · 01-09-2008, 12:20 PM

In most single chambers you do not have to wear the hood!!!!
http://www.nhshealthquality.org/nhsq...T_Revision.pdf

http://www.nationalhealing.com/downl...EOwinter05.pdf
http://www.jenkshbot.com/Default.aspx?tabid=88

http://content.karger.com/produktedb...file=000097876 The discontinuation of bisphosphonate therapy has not helped reverse the presence of osteonecrosis, and the surgical manipulation of the involved site appears to worsen the underlying bone pathology but I disagree with the O2 tx not helping

http://www.drlogueoralsurgery.com/fo...antBISPHOS.pdf

good overall info but like I said HBO 02 helped me, there has not been any good studies that are recent hope this helps Darita (keep me posted as what you decide and how you r doing)

Cathya · 01-09-2008, 01:51 PM

Darita;

I have called the dentist office and told them that I would like to proceed with this oxygen therapy and the assistant said she would begin the process with the surgeon. It is available in the hospital (which I am very familiar with....lol) so I'll just wait now to get more details. I'll keep you informed about how things go. I am so grateful for all of your help. It really is a depressing situation to be in.....and scarey!! You have really helped ease this.

Cathy