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Fluoride Trays

boardwalkgirl
Posts: 263
Joined: Jun 2012

Just found out yesterday that my Medical Insurance Company has approved 80% of my fluoride tray cost. I was initially told that insurance would not pay for them and my dental insurance did deny them but I tried again and it worked. My dentist had recommended these to be used twice daily to protect my teeth. He said he has used these on 5 patients in the past year that had radiation to the head and neck and they have came thru good so far as their teeth. Just thought if anyone else had been told no as to insurance paying they might want to pursue it further, maybe it will work

CivilMatt's picture
CivilMatt
Posts: 2961
Joined: May 2012

Hi boardwalkgirl,

I used a pair of old whitening trays and my dentist gave me a big bottle of fluoride gel. I used it up until radiation treatment and have sporadically post treatment. My dentist recommended that I have teeth cleaning every 3 months instead of the normal 6 months. I am pretty sure insurance will not cover that, but who knows. I really should use the fluoride on a more regular schedule. It is kind of hard to get jazzed up about anything these days. I would like to eat, which I have chosen not to. I guess I might as well work on my teeth.

smiling,

Matt

Oh yeah, good luck with the fluoride treatment, I think it is a very good idea.

hwt's picture
hwt
Posts: 1935
Joined: Jun 2012

Have to say my radiologist laughed when I said I got the trays and told me I wouldn't be using them in a week...I lasted 2 weeks just to prove him wrong. I thought my dental insurance paid but I will double check. Thanks

Laralyn's picture
Laralyn
Posts: 448
Joined: Apr 2012

...and I just resumed using them every night. I wanted to let my mouth heal up a little after treatment. I'm hoping it avoids some of the really bad side effects that can happen to your teeth and jaw. My dentist only told me to use them once a day though!

When I called my dentist the other day, the appointment setter said I should come in every six months. I'll have to check again to see if it should be every three instead!

CajunEagle's picture
CajunEagle
Posts: 361
Joined: Oct 2009

Mine were made for me prior to radiation. I was under the impression that they were to be worn during treatment to reduce damage to the teeth, but that pretty much wasn't the case. I was told just before 1st treatment to not have anything in my mouth. Been using them every morning for the last 3 years, filled with Colgate Gel-Cam, and keeping them over my teeth for at least 15 minutes. Must be working, because I've had zilch tooth problems. I have dental appointments every 4 months.

Larry

Laralyn's picture
Laralyn
Posts: 448
Joined: Apr 2012

I had thick mouth guards for during radiation, and then the super thin trays for using the fluoride gel. I think the mouth guards may have also protected my tongue somewhat, because I seemed to have fewer issues with it burning and hurting than other folks did. The medical center had disposable mouth guards too that they used for people who didn't get them from their dentist. I thought they were standard practice, but maybe it depends on where you need the radiation?

hwt's picture
hwt
Posts: 1935
Joined: Jun 2012

hadn't heard of mouth guards to be used during the actual radiation TX...I would have spent my last dime on lip protectors!

Sam999
Posts: 305
Joined: Mar 2012

What do you put in flouride trays? Is it the the same flouride toothpaste used for brushing? I..e prescription with 1% flouride?

My oncologoist dentist prefers meq brushing the teeth and my regular dentist prefers flouride trays. I dont know which one is right.

I had mouth guards made for radiation, it definately helped as i hace lot of tooth feelings.

Sam

D Lewis's picture
D Lewis
Posts: 1533
Joined: Jan 2010

Hi Sam
My dentist gave me a special PreviDent 1.1% Sodium Fluoride gel to use with my mouth trays. The dentist said that the pH is wrong in regular over-the-counter toothpaste, and if you put it in the trays, it will dissolve fluoride from your teeth rather than depositing it. I believe the PreviDent toothpaste is also pH neutral, and will work in the trays. The PreviDent gel is more runny than the PreviDent paste, and its easier to spread around in the trays.

deb

D Lewis's picture
D Lewis
Posts: 1533
Joined: Jan 2010

I'm two years out from treatment (rads and chemo) and still using the PreviDent toothpaste exclusively. I use my mouth trays and the PreviDent gel maybe once a week or so now. More typically, I will just smear some of the gel over my teeth before I take a shower, (I take long showers), and rinse it out when I'm done showering. So far so good on the teeth. No cavities, no osteoradionecrosis, tongue still burns from the paste, though...

Deb

Sam999
Posts: 305
Joined: Mar 2012

Deb,

I use the same prescription prevident flouride gel but brush my teeth with it. As i mentioned my both dentist differ in opinion on what is best.

My oncologidt dentist thinks when you brrush, you reach in places where trays cannot and it is easier.

My regurlar dentist says trays cover the teeth completely which you might miss with brushing.

At this point i think i will brush one day and use trays next day.

It seems most poeple are using trays verses brushing. Trying to see what did everyone' dentist recommeded. Yours recomended trays?

Thanks,
Sam

D Lewis's picture
D Lewis
Posts: 1533
Joined: Jan 2010

My dentist made me custom mouth guard trays, to use during the radiation, to limit the damage that radiation scatter from my dental work would cause. I was also supposed to use these custom trays with the PreviDent gel during and after treatment. My radiation oncologist refused to let me wear the mouth guard trays during my treatment. I got really bad radiation scatter from my crowns in the back, and the sides of my tongue were very badly burned during treatment. I have scarring on the sides of my tongue now, and my tongue is still quite sensitive to acidic foods and pepper. I'm thinking now that my radiation oncologist was wrong (to put it politely).

My mouth got too sore to brush during the last half of treatment. I flossed, and used the trays. Now I mostly just brush, with occasional tray use.

Deb

Laralyn's picture
Laralyn
Posts: 448
Joined: Apr 2012

... the gel and the paste! I use them both every night. I can only brush my teeth once a day right now because my gums are still so tender!

Viilik70's picture
Viilik70
Posts: 58
Joined: May 2012

I've been using just the Prevident or flouride tooth paste when brushing at night (right before bed) for 17 years and I've been through radiation twice (25 years old & 39 years old) to the head and neck. I think maybe have had one cavity, maybe. I don't use trays.

tommyodavey's picture
tommyodavey
Posts: 358
Joined: Nov 2011

Reading everyone's post it appears that most dentists don't talk to each other about this subject. So many different opinions given by our dentists.

With me, I had periodontal disease in my mid 30's and it required root planing which is much deeper than a deep cleaning. I was told that if I didn't have surgery that I'd lose all my teeth by age 50. (no surgery) I'm 58 and only lost one back molar. I have very large tooth exposure due to my gums pulling up. That means they are healthy but sensitivity has been an issue. What it took was discipline every night and it paid off. My gums haven't bled since I started my routine 22 years ago.

My Oral Surgeon who is part of my cancer team told me to use the trays for 5 minutes every night before retiring to bed. Others have been told 15 minutes so I will ask him that question next time I go in for more fluoride gel.

And for those w/o insurance, the trays shouldn't be too expensive. My Oral Surg gave them to me for cost, no mark up and I paid $35 which included one tube of Colgate Gel-Kam. Buying the fluoride gel from him is $5.00 pr. At cost again.

I say take your teeth very seriously. Here is how I managed to keep my teeth all those years. And yes I've posted this before but your teeth are very important and the goal is not to lose any at all.

Floss every night, that alone is the most important thing to do. Once you get into the habit you'll be done in a couple minutes. Then if you can use a proxy brush to get more tartar out between your teeth. Brush the gum line very easy with a soft brush preferably with a SonicCare or equivalent. Use the fluoride trays for at least 5 minutes or whatever you were told. Yes it is four things to do and takes around 20 minutes from beginning to end. It is just something I know I have to do every night before bed.

Do you really want to lose a tooth? You've heard what happens then. Numerous HBO treatments before they pull it so your jaw will heal. Now that is far worse than doing the preventative maintenance. How about losing all your teeth? At least if you do the work and still lose them you can say to yourself that you did all you could. If anyone is going to lose teeth it should be me. But I won't give them up w/o a fight.

Sorry for the long post and if I sounded preachy I apologize for that too. The sad truth is that the vast majority don't floss their teeth nightly. At least try to make a difference. I'll let you'll know ten years from now if it worked.

Tommy

mls351w
Posts: 88
Joined: Jul 2011

After reading all the comments about this subject, I am really perplexed at the varying "instructions" and "recommendations". As I have posted before, I think your mouth/teeth care is as important as your cancer treatment. I was very fortunate that my ENT referred me to Dr Bruce Barbash, a leading specialist in treating persons who have dealt with head and neck radiation. Dr Barbash deals with everything from simple exams to TOTAL pallet, gum, teeth reconstruction. So, I followed, and still follow his instructions implicitly.
I had my last two wisdom teeth pulled before treatment. Dr. Barbash then carefully measured my gumlines and had floride trays made. These were for floride, not for use during rad treatments. How can a two pieces of rubber protect you from radiation? It seems that every person out there has been told different things. This is what I was told by Dr. Barbash and this is my regimen.

Brush after every meal.
Brush tongue after every meal with a tongue brush.
Rinse mouth with mouthwash. I use a non-alcoholic brand called Act.
Floss after every meal. I use the floss tools called Plackers because I cannot floss with regular floss.
Before bedtime, use the floride trays. I use Prevident Gel, not the paste. The paste is for brushing your teeth, it does not flow well when you apply it to trays. The gel works great. I leave the trays in for a minimum of 10 minutes. That's what the instructions say. No liquids afterwards. Do NOT rinse the floride out. Do NOT swallow the floride. If I leave the trays in too long, and accidently swallow any floride, I have bad abdominal pain later that night.
I have followed the above procedures before treatment, during treatment, and have followed them for the 6 years since treatment. Dr. Barbash is even amazed at the condition of my teeth and gums. No issues what-so-ever!
That's my story if anyone cares.

CajunEagle's picture
CajunEagle
Posts: 361
Joined: Oct 2009

and actually follow the same procedure, except I choose to use Colgate Gel-Cam in the morning after brushing with Prevident 5000. I'm just not a lover of using dental floss, and instead use my tepid water filled Water Pik at least twice a day. It is amazing how much residual food particles are between your teeth when one does not produce much saliva. The Water-Pik has been a blessing ......for me, anyway.

Larry

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