Another Chapter in the Never-Ending Story | by Debbie

Adrienne recently sat in a dentist’s chair for the first time in a while and her mouth was… a mess. We were privileged to have employment-based dental insurance throughout her life so we did ALL the things – regular check-ups and cleanings, fluoride treatments, sealants on her molars to prevent decay from the typical childhood diet of EWWWW BROCCOLI and gummy bears. It was a new dentist and she noted the nonexistence of fillings in Adrienne’s teeth and tactfully started asking about changes in diet or dental hygiene that might account for the five cavities and bone loss in her mouth. Adrienne politely answered all of her questions and then said:

“Nothing there has changed but I did do chemo and radiation treatment for cancer.”

The dentist nodded in acknowledgement because there it was. The reason that my girl’s perfect teeth and jaw were no longer perfect. And another reason why cancer is a never-ending story.

Adrienne recently acquired dental insurance through her husband’s new workplace which is why she went in. The fact that she was able to take advantage of our dental plan until she was twenty-five (a year and a half before her diagnosis) and had zero symptoms of decay meant she was unpleasantly surprised by the exam results. She was able to get four of the five cavities filled right away and is waiting until after the insurance resets in July to take a look at the fifth one. It is very low on the tooth surface and there is bone loss so it’s possible the only course of treatment will be to remove the tooth.

Excuse me while I go scream into a pillow.

I remember my doctor telling me that taking care of your teeth is very important because eating many of the healthiest foods means you have to be able to bite down and chew… HARD. I know it seems obvious but it hadn’t occurred to me that keeping my teeth in good shape would help me maintain the rest of my health. In that moment, though, I looked at her and thought “And how are people who aren’t lucky enough to have dental insurance supposed to afford that?” Now after Adrienne’s check-up I think…

”How are cancer patients, especially young ones who are stopped in their career tracks by a diagnosis that potentially takes them away from employment-based insurance plans, supposed to pay for one more long-term side effect of the only treatment they can agree to that might help them survive?”

In my humble opinion, once you have had chemotherapy and radiation, dental care should shift from an “if you’re lucky and have insurance ” issue into a “this is a medical problem directly related to cancer and we’ll take care of it until you at least hit the golden five-year mark” issue. There are SO many studies that suggest that diet after cancer may impact chances of recurrence but you need to be able to CHEW to eat well. We can tell cancer patients to eat their five fruits and vegetables and whole grains but they need to be able to PAY for those and if their latest dental estimate is the equivalent of a mortgage payment on steroids they are going to have some tough choices to make.

And yes, those all-caps mean I am shouting those words in my head.

My daughter is proof that you can do all the right things and still end up with dental problems from cancer treatment. It would be easy to blame poor oral hygiene for the cavities and bone loss she has experienced in the last four years, but that’s not it. This isn’t an issue of correlation versus causation. The only variable that changed in her life was cancer treatment and she’ll likely be dealing with the fallout for the rest of her life.

Fallout…of her teeth. Get it?

Excuse me. The pillow is calling again.