Do not go gentle

I won’t go into the sad story of my 1940’s model of toothipegs. I’ve got 11 left and they’re now more trouble than they’re worth.

In 2014 my aging teeth were subjected to multiple molar extraction, accidental breakages of my front teeth, and radiotherapy. This can slowly destroy the teeth throughout your mouth unless you’re very careful. But you can’t just tear them all out and replace them with dentures.

Extracting teeth in the radiated area can lead to jaw decay or osteoradionecrosis (ORN).

I thought I’d NEVER have my remaining teeth out because of that and desperately wanted to hang onto to some top ones to hold my partial metal denture. The denture is a powerful device that gives me social acceptability and that most important thing, a smile.

My last cancer was in the buccal mucosa which is the inner cheek and it was right by the bottom gum and jawbone. Teeth, gum and a shaving of bone were removed to get clear margins, giving me a healed wound, half “flap” and half gum, where the lower left gum used to be.

There were no major problems for about five years but as a few teeth in safer areas were extracted and the forces in my mouth changed, the top left molars started chewing on the tissue of the gum and flap below causing it to scar and grow alarmingly.

An attempt to cut the scarred and granulated tissue away was successful for a while because I wore a mouthguard to protect it. But the mouthguard was not the answer in the long run; eventually it broke and the tissue has started to build up again.

It was never a comfortable long term solution. A life of constant discomfort is not nice and almost as bad as pain.

Fiddling around with mouthguards (I’ve had two or three) has broken some of my remaining weak teeth and I’m grazing and biting my tongue too.

The prosthodontist asked me how I was on Friday:

“Terrible, I’ve broken my mouthguard, I’ve broken two more teeth. My tissue is growing again. “

He took one look and came up with a rough plan which depends on a referral to an oral surgeon and is full of risk because of radiotherapy.

The prosthodontist had been watching my case since November and made a snap decision: remove all my top teeth and replace them with a full denture.

On the bottom, place 2 – 3 implants just out of the intensely radiated field and cantilever a denture to fit on top of them over my wound. It will stop growing, even disappear, when it is no longer being chewed he said.

I understand I’d have an upper denture fixed by suction or glue and a lower denture that would fit over implanted plugs or abutments to hold it in place.

The scarily wonderful thing about this is that I would finally have support for my nerveless lower left lip. It wouldn’t suck in uncomfortably. I wouldn’t bite it. I’d have lips back?

That’s something every new surgeon I have seen since 2014 has wanted the prosthodontist to achieve for me but it wasn’t until I saw a super specialist surgeon that someone had the clout to put pressure on the dental team.

No-one’s fault but a heap of issues meant I couldn’t have anything done. I was coping okay, my teeth were semi-stable for a while, the budget at the dental department didn’t stretch to implants. The risk of ORN was high.

There’s still a lot of hesitation about this work. I haven’t had a referral to the oral surgeon yet but the sketchy plan of which I was given a copy, looks hopeful and if they are willing to take a risk so am I.

Imagine having lips and bottom teeth and LESS DRIBBLING for the rest of my life. Wow.