My Teeth -- an Enamel-Coated Conundrum

I've always had good teeth. If I were a horse, I'd get high marks tooth-wise. But the fillings have created another story over the last several months.

The analysis of at least one of the scans (CT, PET or MRI -- I forget which...) done on my head and neck reported that the scan image was blurred in one particular area because the scan radiation was scattered by a filling (or, as it turns out more than one) in my teeth. And wouldn't you know that the area in question turned out to be very close to the location of the primary tumor. So there's always been a bit of doubt about the complete size and location of that initial tumor. (Which is why it has been such a delight to me that doctor after doctor -- and now a dentist -- have physically probed that area in the last several weeks and felt absolutely nothing that suggests residual tumor.)

The other issue with my fillings -- which I've blogged about several times -- was that the X-rays from the radiation treatments scattered off one (or as it turns out more than one) filling and created an ulcer that was extremely painful for months and made eating by mouth impossible. My throat was fine. My tongue was 8-out-of-10 painful when touched by anything. Including tap water.

(In case you missed this part of the story, my tongue has now healed completely. Yay!!)

So today, I was going to deal with this filling issue once and for all. I'd set up an appointment with my dentist, and I was going to have him remove the offending filling (because, in my mind, there had only been one offending filling) and replace it with a totally non-metallic one. One which would not scatter radiation.

(When I discussed this with my radiation doc, he assured me that I would never get any therapeutic radiation in that area ever again. That the bone and other tissue in my jaws had been so changed by the high-level X-radiation of my now-completed treatments that they would not handle any more. Ever. If the primary tumor re-appeared in my jaw area, alternative treatments would have to suffice.)

But I still wanted to have the cleanest possible scans of that area, so I felt that having the filling replaced was a sensible thing to do.

The first thing my dentist did was to take x-rays of my teeth. He assured me that the dosages from his x-ray machine were miniscule in comparison to those of my therapy, so... okay... I guess...

While the x-ray films were developing, he cleaned my teeth and we chatted.

When the films were ready, he popped them onto the screen and showed me how well my teeth were behaving, and that all the fillings were in great shape. He then was clearly ready to escort me back to the waiting room so I could pay my bill.

"But wait!" I said, "how about replacing the filling? Should we do that on my next visit or what?"

Now, he didn't actually say "Ooops," but he might have well done so. It seems that I had not fully explained the purpose of my visit, or the filling issue had slipped his mind or something. But in any case, it was clearly not on his agenda for the day.

So I explained the reasons why I thought replacing fillings was a good idea, and he looked over at the films, which were still hanging on the viewer. He said, "Well, my guess is that it would be that filling right there. Or possibly this one here. Or maybe the crown on this tooth here."

In short, the scatter issue was probably not caused by a single filling in a single tooth, but multiple pieces of metal in multiple teeth.

There were at least five teeth on that side of my mouth that could have contributed to the scattering issue. The dentist said, "If you want me to start over here by replacing that filling, then start moving across to the rest of these other teeth, I can do that. It'll take some time to get it all done, but it's up to you."

Hmmm... I don't think so. Maybe we just leave the teeth alone and be grateful that they are healthy and should last for the duration. Something about: "If it ain't broke..."

The blurry image from the scan/scattering issue will be there as always, but now, the possibility of a metasticized tumor showing up elsewhere -- away from my teeth -- becomes an issue at least as important. So we let the tooth-fixing issue go. At least for the time being.

Somehow, I find all this more confusing than it seems it ought to be.