Need Advice Pertaining to Dental Work... - Advanced Prostate...

Advanced Prostate Cancer

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Need Advice Pertaining to Dental Work and Tx

compiler profile image
15 Replies

I have a problem with a molar. It has a crown. But there is a cavity under the crown invading the root area. No pain or any discomfort for me... yet. Dentist says we need to pull that tooth and a wisdom tooth. I can then see how that goes and consider an implant. He is referring me to an oral surgeon. Their office specializes in that stuff and has good reviews.

My question: I know one doesn't want to be on drugs for low bone density due to jaw necrosis issues. Not an issue for me. But I have a rising PSA. Next PSA in 3 months or so. If PSA rises, we do a Pylarify PSA scan possibly followed by HT and then SBRT. Is the aforementioned kind of dental work a bad idea given that scenario?

Of course, if dental issues (pain) arise, my hand is forced.

Anyone have an implant for one tooth? Is it worth it? I am 76 years old.

Mel

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15 Replies
tango65 profile image
tango65

Osteonecrosis of the jaw in people taking bone agents is more frequent when there are infections in the teeth or dental procedure such of extractions and implants. If you are not in bone agents treatment, it seems prudent to take care of the dental problems you have ASAP.

compiler profile image
compiler in reply totango65

Maybe I wasn't clear. No bone agents. But would being on HT + SBRT make dental surgery risky?

Mel

tango65 profile image
tango65 in reply tocompiler

The risks in relation to osteonecrosis of the jaw are not increased.

allie2020 profile image
allie2020

I lost a tooth 20 years ago and got an implant. Absolutely no issues and it's been perfect. The oral surgeon and dentist work together, each performing their part. The whole process takes some time, several months at least. The oral surgeon will test your bone in your jaw to be sure an implant is the right choice. I believe in most cases, an implant is a much better alternative than a bridge. The oral surgeon should be able to answer all of your questions.

Hey guy! I had an implant attempted on a gold crown gone bad on a molar .. Unfortunate for me I’ve had major bone density loss and I’ve taken prolia for over 4 yrs . The bone collapsed around the implant .. Rather than a costly bridge on an already crowned wisdom tooth I now how a tooth missing . But I can’t see it really . I just paid$500 last week to temp fix another cavity on another adjacent molar . If it fails I’ll just pull it . My jaw bone doesn’t hold up for an implant . I’m 61 .. Good luck at stopping the Psa rise ! Scott

Muffin2019 profile image
Muffin2019

I had to have root canal done, did not have a crown but the dentist did a great job of building up the tooth, you would never know it was a fake. I do not do nuts so still careful on that side, the root canal was not fun as they had to put a temporary filling in twice before the permanent filling. I have never gotten implants, even when age 60's not worth the price and especially in my present age of 71. Just have to be diligent in brushing and prevent any infections in ghe tooth. I would vote no on an implant.

GMorz profile image
GMorz

Hi , I am a Dentist in Australia. I would personally avoid dentally extraction if able to . Their may be an alternative to do root canal therapy and save the tooth. Similarly extract wisdom tooth only if heavily decayed needing root canal.If absolutely needed to extract , oral surgeons can monitor post operative to reduce the risk of osteonecrosis. I would not be having an implant. You will function perfectly with a missing tooth.

I think you are being over treated and dentist not looking at big picture and each case should be treated on its own merit. I would not do this to you if you were my brother or father and is how you should be treated not just for $$.

rsgdmd profile image
rsgdmd

I'm a retired dentist. If the tooth can't be saved, get it out now, rather than wait and possibly be on osteoporosis meds & need an extraction. If the 3rd molar is OK, leave it. Personally, I'd skip the implant. I lost a 2nd molar and planned for an implant; didn't miss the tooth, so I have one less tooth.

Don_1213 profile image
Don_1213

A skilled endodontist can often save a tooth, and the crown by doing the root canal through the top of the crown. BTDT on several molars. Most general practice dentists don't do enough of these to be really skilled at it - and the best one will have an endodontist who they can recommend. It will be costly, but less costly than an extraction, implant or bridge. If you're in NJ I have a guy I can suggest (in Brick NJ).. painless and meticulous.

dentaltwin profile image
dentaltwin

Also retired dentist here--there should be no specific problem with extractions and placement of the implant. Radiation is an issue--but only if you're getting radiation in the head/neck.

As far as whether an implant is advisable, it may be--depending on how much you're likely to miss the tooth. I've seen aggressive oral surgeons placing implants where there is no opposing tooth. But if you are able to do it financially, and esp. if your overall prognosis is good I see no reason why you can't do it.

If you have a lot of other missing teeth in that jaw, it would be much quicker, easier and cheaper to have a partial denture made.

j-o-h-n profile image
j-o-h-n

Wow, 3 dentist's advice and no fee...... See why being here is so advantageous....Next time contribute to your favorite cancer care organization.....

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 06/28/2022 7:35 PM DST

NotDFL profile image
NotDFL

Note that an implant requires 'good' bone to hold it. Also note, in case that isn't clear right now from the nice posts above, that an implant procedure takes several months and requires a crown on top. That adds up moneywise!

Bethpage profile image
Bethpage

Any chance that the location could be treated with a bridge? My husband has genetically poor teeth, but has had a really great bridge that has lasted for over 40 years.

compiler profile image
compiler

Thanks for the comments. Arguments for all kinds of modalities (reminds me of PC Txs!). My appt. to see the surgeon is 8/30. It is just for a consultation. That's earliest appt. On a waiting list for something quicker. I know they do a major implant business so I expect them to push that. I am going to ask strongly about root canal and I am leaning towards either extraction or, probably, doing nothing. I generally chew on my left side, where the issue is. I have zero symptoms. I'm thinking of consulting with an endo specialist after I see what this guy says. Also: my wisdom tooth had a cavity maybe 12 years ago. I insisted my dentist fill it; he wanted to pull it. Recently, that filling came out, but again no symptoms whatsoever. I can wait. SHALL WE CONSIDER THIS DENTAL AS?

rococo profile image
rococo

Ithink some dentist opt for pulling teeth to avoid complications inflammation, slow growing cavity etc all of which can be monotored and treated, Haven’t had a treated in three decades yet they keep finding shadows

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