should I agree to teeth extraction before RT start or can I keep my teeth

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Hi there,

I am 49 years old female, that was formally diagnosed none HPV tonsil cancer,  just couple of weeks ago, having found that in the lymph node originally. I never smoked, drank occasionally and have health diet and life style. had surgery to remove the tonsil and yesterday had a dental assessment pre-Radiotherapy that left me entirely devastated. I always looked after my teeth and had lots of dental work through the years, but the dental consultant suggested that I should remove 4 teeth on one side and 3 on the other, basically most of my molars will be gone! He explained that this is to reduce the risk osteoradionecrosis, but when I asked for the statistics, he told me that is 8% probability, in my case probably higher because I take alendronic acid. The prospect of reconstruction of the teeth is minimal, so I wonder what will happen if I choose to keep my teeth rather than follow the advice because of the 8 % chance. This is my second cancer rodeo, I am in remission for breast cancer and had double mastectomy, so I feel that have very little in the tank to fight this. What is your experience with this as it seems that the quality of life is diminishing following the teeth extraction and the suggested RT and Chemo? 

  • Hi  

    if i was in your position and was sure the teeth under scrutiny are sound i would keep them. But this is just my opinion. I had none out despite being prescribed RT both sides. Two years later I did have to have one wisdom tooth extracted and everything went well. 

    Dani 

    Base of tongue cancer. T2N0M0 6 weeks Radiotherapy finished January 2019

    I BLOGGED MY TREATMENT 

    Macmillan Support Line -  0808 808 00 00 7 days a week between 8am-8pm

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  • I had 3 molars extracted prior to CRT .... just rolled with the punches... it's a difficult treatment and recovery so I tried to do the best thing for myself with the information available, everyone is different.

    I also had a run-in with colorectal cancer previously so I can kinda understand where you're coming from...my quality of life was impacted negatively for a few months... things improved greatly 6 months or so after finishing the Chemoradiotherapy for the head and neck cancer.

    Michael

  • I had 5 removed wisdom teeth and molar ,if i were you i would keep them if they are in good condition .You will have to spend longer looking after them after treatment but its a small price to pay .

  • I had 5 removed wisdom teeth and molar

    Were they in bad nick? 
    Some trusts seem to have them out with gay abandon. My teeth are all heavily restored thanks to industrial quantities of asthma syrup as a youngster but they were left alone. 

    Dani 

    Base of tongue cancer. T2N0M0 6 weeks Radiotherapy finished January 2019

    I BLOGGED MY TREATMENT 

    Macmillan Support Line -  0808 808 00 00 7 days a week between 8am-8pm

    Community Champion badge
  • I didn't have any teeth out, despite having lots of childhood fillings, a crown and a root canal job. I look after my teeth well and haven't had any fillings or problems for years. I was surprised but pleased to be told I didn't need any pre-treatment extractions. Three years after finishing chemoRT my teeth are still fine. If your teeth are sound and you don't have gum disease I think you could opt to keep them. Just be super-conscientious with your dental hygiene from now on. 

    Good luck! 

    September 2022 aged 63 diagnosed with HPV associated SCC base of tongue T4 N2 M0. Chemo & radiotherapy for 6 weeks ending Nov 2022. Now over 3 years all clear. See my profile for longer story

  • Thank you CatSW9, I look after my teeth religiously and have lots of dental work done over the years , including root canals and crowns and a bridge. I felt that they simply wated to take out everything that had work on, even 2 completely healthy teeth where I would have nothing to chew on if the bottom ones were removed. I was horrified from the prospect losing so much and having no options for implants in the future.  They even recommended to remove teeth on the healthy right side because of of how the RT ray will travel. 

  • I had a long hard talk with the dental surgeon at the hospital and decided that I would keep all mine rather than lose any that were a little suspect.  They promised that they would deal with anything that went bad later on.  2 years down the road and I still have all the teeth I started treatment with and no sign of any problems with them.  Keep yours if you can.

    Peter
    See my profile for more details of my convoluted journey