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Author |
Topic: Teeth/Dentures/etc |
TammiW
Member
Member # 109
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I'm really discouraged by the few things I've read regarding
replacing a patient's teeth. All of my sister's teeth were
extracted during surgery. She will start radiation next week.
Meanwhile, the doctors don't seem particularly concerned about
her having to go around with no teeth which angers me to no
end. I read one of your posts regarding an acrylic gizmo called
a "flipper." Where might this gadget be available?? From what
I've read on others' experiences, she won't be fitted for
dentures anytime soon, and especially not by the time she
plans to return to work. I'm totally boggled on this subject.
Thank you Brian.
Posts:
5 | Registered: Apr 2002 |
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Brian
Hill
Administrator
Member # 4
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A flipper (a simple removable PARTIAL denture made from plastic)
is only a temporary device, custom made for a particular individual,
by a dentist and lab, that will replace one or two teeth.
It is no good for eating, only looks. A person who has had
all their teeth extracted needs a complete denture, and this
is a whole 'nuther animal. Teeth that are marginal for long
term survival, have extensive decay, have periodontal problems,
etc. must be extracted before radiation, as any post radiation
extraction will cause severe consequences. If the teeth were
extracted, the doctors must have felt that they were in bad
shape or the surrounding tissue and bone had perio problems
that might have caused them to be lost after radiation. Teeth
are not arbitrarily extracted prophylacticly.I had a healthy
mouth before radiation, and had no extractions. But if there
is a chance that a tooth will be lost later, the consequences
of osteoradionecrosis are so dire, that doctors will not risk
it.
While it may be difficult to go without teeth right now, I
would think that the bigger issue would be beating the cancer,
(staying alive), and waiting for a long-term result that will
include making new dentures once things have healed properly.
Her mouth is going to be changing physical shape during the
healing from the surgery, and any denture made now would not
fit in 90 days, rendering it useless. The radiation is going
to cause significant mucositis, and she will not want anything
resting on top of that sore, tender tissue like a denture.
All things have to happen in their due time, and I am sure
that as soon as it is practical, she will have her first full
denture made by her doctors. As to having this done by the
time she is ready to return to work, she may find that after
a few weeks of getting beaten up by the radiation treatments,
that that time is further away than she may think today.
--------------------
Brian, stage 3 oral cancer survivor. OCF Founder and Director.
"The first responsibility of a leader is to define reality.
The last is to say thank you. In between, the leader is a
servant."
Posts:
364 | From: Laguna Beach, CA | Registered:
Mar 2002 |
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TammiW
Member
Member # 109
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That "bigger issue" you mentioned IS the most important thing,
and I knew you were going to say that. But I thank you for
the information.
Posts:
5 | Registered: Apr 2002 |
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chabrn
Member
Member # 35
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Tammy,
Brian is right about the risk of osteoradionecrosis. I had
all my teeth removed prior to radiation treatments, so I know
how your sister is feeling. She will not think so much about
having teeth during her treatments. After radiation is over
she will need time to heal, and during this period is when
it got to me. When I began to feel better I wanted my teeth
back. It was one year before they fitted me with a top denture
and eighteen months before I got a bottom denture. Of course,
no two people are the same and your sister may get them sooner.
I just want you and your sister to know that it will happen
and things will get better. It took me awhile to go out in
public without teeth (fear of people looking at me), but I
got over that and she will too. I'll be praying for you and
your sister and if I can help in any way let me know. Anita
Posts:
12 | From: Iowa | Registered: Mar 2002
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Brian
Hill
Administrator
Member # 4
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In reading my previous post this AM, I realize that it came
across a little harsh as to priorities. I'm sorry, this has
been a week of several OCF acquaintances losing their battle,
and I'm a little sensitive to priorities right now. It has
nothing to do with whether or not your esthetic concerns are
important, they of course are. The whole person is being treated,
and esthetics and self-confidence are of course a genuine
and valid concern.
If your sister handles the radiation treatments well, there
is an intermediate step that the prosthodontist may take to
give her more comfort in public or at work. This is commonly
referred to as an "immediate denture," which while still made
of hard plastic and plastic or porcelain teeth, is lined with
a soft resilient liner. The soft liner is readapted to the
changing contours of a patients mouth every couple of weeks
in a simple chairside procedure. Since this denture is for
esthetics primarily more than chewing, it is likely that just
the maxillary denture would be initially made, as this impacts
the shape of the face and the smile more than anything else.
But even this step may be some time off. The doctors are going
to want the soft tissues to heal from the radiation induced
mucositis as much as possible first, and that means after
radiation has ended.
One of the issues that she should be aware of, and working
on during treatments, is radiation induced trismus which you
can read about in the web site. With totally edentulous patients,
the tendency for the vertical dimension between the two arches
to decrease is more likely since there are no teeth to help
maintain the space. As the effects of trismus become more
pronounced, this will potentially cause problems later when
her final dentures are made. It is important that she maintains
this inter-arch space through stretching exercises throughout
her treatments and for months after radiation has ended.
--------------------
Brian, stage 3 oral cancer survivor. OCF Founder and Director.
"The first responsibility of a leader is to define reality.
The last is to say thank you. In between, the leader is a
servant."
Posts:
364 | From: Laguna Beach, CA | Registered:
Mar 2002 |
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