ADT and dental problems

My teeth started falling apart the week that I started radiation, which was at ten months on Lupron. I blamed it on many of my crowns being thirty years old. So far I have spent around $20,000 on replacement crowns and implants in the past 18 months.

I asked the oral surgeon specifically about HT and he said as long as I had not had any bisphosphonates or Prolia then there should be no cause for concern. Fortunate, as I had considered Prolia as I was already osteopenic a decade before the Lupron.

I too saw that other thread (I think it was Sr Sailor's reply) and figured it wasn't worth correcting, as it was not entirely accurate... unless there's something I don't already know. AFAIK it is the bone density meds that can cause ONJ, not the HT itself.

It could also be coincidence. Don't overlook how long since the failing dental work was done. I went through a period in the 1990s when many of my old fillings, many dating back to my teen years, needed to be replaced with crowns. I'm now at the point where most of my crowns are 20 or more years old. I just had to have one replaced on a tooth that had a root canal and crown in the early 90s. The dentist didn't offer much hope of attaching a new crown to what was left of the tooth, but over the course of three visits she did it and also got to use me as a teaching opportunity for a dental student. I told her that if it is still in place in two years I'll nominate her for the Nobel prize in dentistry.

However I don't disagree about wondering what dental work is needed and what is "upsell." Two years ago I qualified for dental care at the VA after my prostate cancer was active again, which increased my VA rating due to Agent Orange exposure yada, yada. My previous private dentist was pushing me toward deep scaling to the tune of $700 per quadrant, and possibly further gum surgery to the tune of a thousands more.

When I switched to the VA they set me up with a regular dentist, a hygienist, and also a periodontist. I see the perio twice a year and he cleans a bit deeper and more aggressively than the hygienist, but nothing that requires Novocain. and he hasn't yet suggested gum surgery. This leads me to wonder if my former private dentist was over-selling or was maybe just being more cautious. I could also wonder on the other hand if the VA is doing a less thorough job to save money, but the evidence certainly doesn't point in that direction - especially given I've just had hours of work over several appointments by my regular VA dentist to save a tooth that was borderline at best and they could have simply pulled.
Jim