Dry Mouth and Cavities.
Had a good talk with my dental hygenist yesterday about preventing cavities after receiving radiation. I had assumed it was because of the rads that the teeth start to get them and that is why we use flouride trays. She told me it was due to having a dry mouth and that your saliva does a great job at protecting the teeth. I told her the only time my mouth is dry is when I'm sleeping. It wakes me up several times a night until I spray it down. So the flouride is to protect the teeth even though they dry out. And BTW, this never happened until I had my surgery. I've always slept with my mouth closed up until now.
Over the last two years I've tried almost everything. Head bands that seem to work okay but only lasted two weeks. ($45) Some of the others were over $100 and I've been reluctant to buy one and have it not last long either.
Why hasn't this issue been resolved many years ago? I'd love to try to make one that works and sell it myself but my motivation is not the greatest. Does anyone know of one that actually keeps the mouth closed while sleeping? I'll spend the money if it's a quality product. Thing is, I still have one working major salivary gland so it's not a lost cause. During the day I'm fine.
Next week I'm meeting with my Oral Surgeon and will discuss this. If he has an answer, I'll post it.
Tom
Comments
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Hi Tom
Sorry but other than taping my mouth closed it will open and dry out, but I have found a product called Stoppers 4 for dry-mouth that has for me worked the best. I am right at 12 years passed my first treatment for NPC and 10 years passed my second. I have a lot of side effects I live with and so far I am doing pretty good with it. My biggest problem is not being able to open my mouth more than ½ inch and that make it hard to see a dentist, most of them when I walk in just say I am sorry but there is nothing we can do for you. I am glad that after years I finial did find one who has been helping me, but as you would know he is not a PPO of my health plan. Well Oh is all I can say, I don’t care I am going to see him no matter what.Health plans don’t understand real life events.
All the best to you next week with you Oral Surgeon
Tim Hondo
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What about those
Breathe Right strips? Thinking that maybe when you sleep you can't get enough air through your nose, so you automatically breathe through your mouth? When I was in treatment I kind of trained myself to hold onto my bottom lip with my teeth....I've woken up with red marks from holding on too tight. Doesn't work so good now that I'm not sleeping sitting up, I still wake up dry as a bone. If your dentist can figure out something, be sure and share it.....I hate being able to knock on doors with my tongue in the morning.
p
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Dry Well
I was actually doing really well until recently. I've been waking up with dry mouth the last couple of months. Funny thing is, as soon as I get up, the saliva starts flowing and a little sip of water does the trick. I agree with P concerning the nose strips. They help a lot. I was using Oral Balance but the formula changed and it's not as effective. I also find lying on my back poses a problem with saliva flow. Lying on my side seems to be better. Fortunately, my ora/dental care team keeps up on things and so far so good.
Good luck next week!
Positive thoughts and prayers.
"T"
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two things..
Great post on a topic near and dear to us all.
Post-tx dental issues fall into two cateogires. One group is jawbone/ORN, primarily caused by radiation. Tooth decay issues are related to lack of saliva and not radiation related.
As I got past treatment and into recovery, concern grew about longer term oral health so I focused on effects of radiation and lack of saliva as primary causes for posttx dental decay issues. Saliva has good bacteria that destroys bad bacteria causing cavities. If you have low saliva production, all the stuff to make your mouth feel wet is not helping unless it contain similar agents having the same effect as natural saliva. Anything promoting saliva generation or prevents it lose via open mouth breathing and such is a good thing.
Effects of radiation on the jawbone is more the hot topic as this relates to ORN, something we all shudder about. The radiation can damage the tissue around the bone and teeth which keeps the bone healthy. Over time, the health of the bone/teeth goes down and starts decaying leading to loosening of teeth and jawbones needing to be relpaced. All nasty stuff.
I used to think direct radiation on the teeth created long term side effects but as Tommy points out I think less so now. The majority of the damage done by radiation is to the tissue around the teeth and jawbone and not the actual bone/teeth then maybe the teeth are pretty much intact. You don't hear much about survivors teeth just disingrating. Rather, it falls into one of these two categories.
Just an aside - flouride trays. Many folks get into a tizzy over this one but it seems pretty simple. If you have normal saliva production, then flouride trays are not necesary as the saliva is doing it job. Normal brushing, flossing, and waterpik use seem plenty sufficient. If you have compromised saliva production then trays are likely a good thing. But I don't think using flouride trays is a full substitute for normal saliva production in terms of keeping the cavities away. I'm thinking 24-7 saliva protection is going to be better than a few minutes of flouride on the teeth. Even then it is only treating the actual teeth and not doing much for the bacteria around gum tissue.
Anyway, one of my favorite post-tx topics. Just my two cents. Don
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Good Stuffdonfoo said:two things..
Great post on a topic near and dear to us all.
Post-tx dental issues fall into two cateogires. One group is jawbone/ORN, primarily caused by radiation. Tooth decay issues are related to lack of saliva and not radiation related.
As I got past treatment and into recovery, concern grew about longer term oral health so I focused on effects of radiation and lack of saliva as primary causes for posttx dental decay issues. Saliva has good bacteria that destroys bad bacteria causing cavities. If you have low saliva production, all the stuff to make your mouth feel wet is not helping unless it contain similar agents having the same effect as natural saliva. Anything promoting saliva generation or prevents it lose via open mouth breathing and such is a good thing.
Effects of radiation on the jawbone is more the hot topic as this relates to ORN, something we all shudder about. The radiation can damage the tissue around the bone and teeth which keeps the bone healthy. Over time, the health of the bone/teeth goes down and starts decaying leading to loosening of teeth and jawbones needing to be relpaced. All nasty stuff.
I used to think direct radiation on the teeth created long term side effects but as Tommy points out I think less so now. The majority of the damage done by radiation is to the tissue around the teeth and jawbone and not the actual bone/teeth then maybe the teeth are pretty much intact. You don't hear much about survivors teeth just disingrating. Rather, it falls into one of these two categories.
Just an aside - flouride trays. Many folks get into a tizzy over this one but it seems pretty simple. If you have normal saliva production, then flouride trays are not necesary as the saliva is doing it job. Normal brushing, flossing, and waterpik use seem plenty sufficient. If you have compromised saliva production then trays are likely a good thing. But I don't think using flouride trays is a full substitute for normal saliva production in terms of keeping the cavities away. I'm thinking 24-7 saliva protection is going to be better than a few minutes of flouride on the teeth. Even then it is only treating the actual teeth and not doing much for the bacteria around gum tissue.
Anyway, one of my favorite post-tx topics. Just my two cents. Don
Great responses from all. Donfoo, you are 100% correct on the description of rads on teeth and jaw. I do use Stoppers 4 and one other generic from CVS that tastes okay. It's funny how I lay there trying to get my saliva going and nothing happens until I stand up, then it flows just right.
Hondo, funny you mention tape. I was really waiting for someone to tell me to use duct tape! I've been told that many times when I explain it to someone. It's a guy thing. Duct tape fixes everything.
I do the flouride trays because they told me to. 25 years ago I had gum disease. The Periodontist told me I'd lose all my teeth before 50 unless I had surgery to tighten up my gums. I didn't have it because one of the hygenists told me how to take care of my teeth. She told me if I do what she says everyday then my gums will tighten up themselves, which they did. I'm 60 years old and have lost only one back molar. My dental routine takes me just about ½ hour before bedtime. It used to be less time until I added the trays. I will do whatever is necessary to keep my teeth and gums healthy. Two years out, so far so good. I really don't mind the trays because the flouride helps with sensitivity to hot and cold.
Next Tuesday is my appt. I'll try to remember to post back then.
Tom
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Always learningtommyodavey said:Good Stuff
Great responses from all. Donfoo, you are 100% correct on the description of rads on teeth and jaw. I do use Stoppers 4 and one other generic from CVS that tastes okay. It's funny how I lay there trying to get my saliva going and nothing happens until I stand up, then it flows just right.
Hondo, funny you mention tape. I was really waiting for someone to tell me to use duct tape! I've been told that many times when I explain it to someone. It's a guy thing. Duct tape fixes everything.
I do the flouride trays because they told me to. 25 years ago I had gum disease. The Periodontist told me I'd lose all my teeth before 50 unless I had surgery to tighten up my gums. I didn't have it because one of the hygenists told me how to take care of my teeth. She told me if I do what she says everyday then my gums will tighten up themselves, which they did. I'm 60 years old and have lost only one back molar. My dental routine takes me just about ½ hour before bedtime. It used to be less time until I added the trays. I will do whatever is necessary to keep my teeth and gums healthy. Two years out, so far so good. I really don't mind the trays because the flouride helps with sensitivity to hot and cold.
Next Tuesday is my appt. I'll try to remember to post back then.
Tom
I got to thinking more about effect of rads on teeth and the 2014 NCCN guideline doc now includes for the first time a section on dental related issues for HNC. It reminded me about demineralization of the hard teeth has been discussed here and seems to be one of the reasons for grinding teeth to the gumline. Anyway for those wanting more specifics from the the authoritive source, go here
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Simple solutiondonfoo said:Always learning
I got to thinking more about effect of rads on teeth and the 2014 NCCN guideline doc now includes for the first time a section on dental related issues for HNC. It reminded me about demineralization of the hard teeth has been discussed here and seems to be one of the reasons for grinding teeth to the gumline. Anyway for those wanting more specifics from the the authoritive source, go here
Hi, my saliva not to bad but if I sleep face down it keeps my mouth shut. Not too much achieves that!
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Wonder if a chin support designed for Cpap would help
Found this on Amazon. Reading the comments under the product written by Amazon customers is helpful. This particular product is not expensive so maybe worth a try. This is just an image of the product ... you would need to do a search on Amazon using the product name if you might be interested in considering such a device. I have no personal experience with this type of device so I don't know if it would help with night-time dry mouth associated with loss of salivary gland function. I hope it is okay to post this image ... I am not promoting this product ... it just looked like a device that might help those having difficulty with dry mouth from breathing through an open mouth while sleeping. If posting this is against csn policy, then please delete it. Apparently the "Extra Large size fits most adults better than the Small Thru Large and it seems to have velcro adjustments.
CareFusion Ruby Adjustable Chin Strap
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Sonic caretommyodavey said:Good Stuff
Great responses from all. Donfoo, you are 100% correct on the description of rads on teeth and jaw. I do use Stoppers 4 and one other generic from CVS that tastes okay. It's funny how I lay there trying to get my saliva going and nothing happens until I stand up, then it flows just right.
Hondo, funny you mention tape. I was really waiting for someone to tell me to use duct tape! I've been told that many times when I explain it to someone. It's a guy thing. Duct tape fixes everything.
I do the flouride trays because they told me to. 25 years ago I had gum disease. The Periodontist told me I'd lose all my teeth before 50 unless I had surgery to tighten up my gums. I didn't have it because one of the hygenists told me how to take care of my teeth. She told me if I do what she says everyday then my gums will tighten up themselves, which they did. I'm 60 years old and have lost only one back molar. My dental routine takes me just about ½ hour before bedtime. It used to be less time until I added the trays. I will do whatever is necessary to keep my teeth and gums healthy. Two years out, so far so good. I really don't mind the trays because the flouride helps with sensitivity to hot and cold.
Next Tuesday is my appt. I'll try to remember to post back then.
Tom
tom, losing my teeth are one of my biggest concerns as well. Do you use, or have you tried, the Sonic Care toothbrush? I brush my teeth multiple times a day and brushing can be really tough on gums because the brushing motion naturally pushes the gums away from the teeth. The Sonic Care really helps with that.
I still have some mouth issues and I'm 13 months since my last treatment. I can't keep the Thrush at bay. I'm on a preventative dose of dyflucan and I stay off of it as long as I can but I had to start taking it today. In a few days it will be gone so just a PIA and the Dr says no issue taking it long term if needed. I use a fluoride tray as well and my thinking is why not if it could even possibly help the teeth. As you know it's a piece of cake to use them and I have my nightly routine. I also bought a WaterPik for flossing and sprayed water all over the bathroom the first time I used it! Most things the button on the handle starts things but not on the WaterPik. I'm a much better aim now and most of it hits in mymouth.
Good luck Tuesday,
Keith
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Chin Strapalligatorpointer said:Wonder if a chin support designed for Cpap would help
Found this on Amazon. Reading the comments under the product written by Amazon customers is helpful. This particular product is not expensive so maybe worth a try. This is just an image of the product ... you would need to do a search on Amazon using the product name if you might be interested in considering such a device. I have no personal experience with this type of device so I don't know if it would help with night-time dry mouth associated with loss of salivary gland function. I hope it is okay to post this image ... I am not promoting this product ... it just looked like a device that might help those having difficulty with dry mouth from breathing through an open mouth while sleeping. If posting this is against csn policy, then please delete it. Apparently the "Extra Large size fits most adults better than the Small Thru Large and it seems to have velcro adjustments.
CareFusion Ruby Adjustable Chin Strap
Thanks for posting the picture. And yes, I've tried one of those and they only last a week if you're lucky. The elastic stretches out very fast. There are others I may try that cost close to $100. It better work if I'm putting out that much money.
My routine of cleaning my teeth is one of the best, so says my dentist and hygenist. I never have any plaque built up due to the flossing, etc. The WaterPic has been recommended by not only you guys here but also by my dental team. The only complaint I heard was the water going everywhere. If someone will tell me how NOT to do that I'll appreciate it. It's on my list of things to buy.
Another thing is that I can only sleep on my back due to shoulder surgeries years ago. My nose is clear so breathing isn't an issue if I could keep my mouth closed. Oh, and yes, I do have a new Sonicare toothbrush. My old one fried in Africa. I used a convertor to charge it and I'm lucky it didn't start a fire. The whole base expanded and quit working so I bought a new one and it is sooo much better than the last one. The new brushes they make work so much better at getting the stain off from the Stanis Flouride. Funny how little things like that can give a person so much joy.
That's my update ya'll. Thanks for all the tips.
Tom
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Water Pic usagetommyodavey said:Chin Strap
Thanks for posting the picture. And yes, I've tried one of those and they only last a week if you're lucky. The elastic stretches out very fast. There are others I may try that cost close to $100. It better work if I'm putting out that much money.
My routine of cleaning my teeth is one of the best, so says my dentist and hygenist. I never have any plaque built up due to the flossing, etc. The WaterPic has been recommended by not only you guys here but also by my dental team. The only complaint I heard was the water going everywhere. If someone will tell me how NOT to do that I'll appreciate it. It's on my list of things to buy.
Another thing is that I can only sleep on my back due to shoulder surgeries years ago. My nose is clear so breathing isn't an issue if I could keep my mouth closed. Oh, and yes, I do have a new Sonicare toothbrush. My old one fried in Africa. I used a convertor to charge it and I'm lucky it didn't start a fire. The whole base expanded and quit working so I bought a new one and it is sooo much better than the last one. The new brushes they make work so much better at getting the stain off from the Stanis Flouride. Funny how little things like that can give a person so much joy.
That's my update ya'll. Thanks for all the tips.
Tom
I've been using Water Pic for many years now, and I really believe it has saved me a ton of pain and agony. It's now become part of my life in using it pretty much after every meal. Recently I've gone to using the Water Pic tool with the little brush on the tip to sooth the gums, while letting the tepid water force particles out from between my teeth. In using the Water Pic, place luke warm water in the tank, place tip in the area of your teeth in your mouth, turn on the switch at the lowest possible setting then slowly increase the amount of water pressure. This should keep it from having water fly all over the place. Also, every now and then, I use a cap full of floride treated mouth wash in the tank along with water. Act seems to work best for me. Someone last Christmas gave me a Phillips Sonicare portable battery operated water pic device, that works by pushing a button and a strong "snap" of water is forced out of it's tip to get between teeth. It's good for traveling, but I'm not crazy about it.
Larry
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take a bite out of this
Tom,
2y4m, started with 28 teeth and still have 28 teeth, with good check-ups. I brush and floss daily and fluoride routinely. While I can sleep through the night unaided, I use a couple of Xylimelts at bedtime to help keep my mouth moist. For what it is worth, I think it helps.
My mouth and teeth feel fine, no pain, but in many ways it feels like my last rad was yesterday.
Matt
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Water PicCivilMatt said:take a bite out of this
Tom,
2y4m, started with 28 teeth and still have 28 teeth, with good check-ups. I brush and floss daily and fluoride routinely. While I can sleep through the night unaided, I use a couple of Xylimelts at bedtime to help keep my mouth moist. For what it is worth, I think it helps.
My mouth and teeth feel fine, no pain, but in many ways it feels like my last rad was yesterday.
Matt
Thanks Larry for the good advice. I've been told that the water pic gets all the tartar off so no need to floss. Does that sound right to you? It would save me a lot of time if it works that well.
Matt, you and I are almost neck and neck with treatment dates. I had my last rad on April 2, 2014. So, 2yrs/3mo. out. Does your mouth open up when you sleep? Do you think the Xylimelts will help with an open mouth with no saliva flowing?
Thanks to both of you for the tips.
Tom
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extra pillowcasestommyodavey said:Water Pic
Thanks Larry for the good advice. I've been told that the water pic gets all the tartar off so no need to floss. Does that sound right to you? It would save me a lot of time if it works that well.
Matt, you and I are almost neck and neck with treatment dates. I had my last rad on April 2, 2014. So, 2yrs/3mo. out. Does your mouth open up when you sleep? Do you think the Xylimelts will help with an open mouth with no saliva flowing?
Thanks to both of you for the tips.
Tom
Tom,
March 23rd.
I sleep with an open (drooling) mouth. It is open and dry without the Xyilimelts. They are funky, but they work for sleep or when I need a wet mouth.
Matt
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Tom
As Don has stated a big issue is bacteria. The hygenist at my dentist told me I should use mouthwash. Listerine even came out with one with no alcohol that will not dry your mouth out especially at bedtime. I use that then use my special flouride touthpaste before bedtime. Hell even after all that my wife thinks I still have a dirty mouth.
Jeff
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Flossing and stuff...tommyodavey said:Water Pic
Thanks Larry for the good advice. I've been told that the water pic gets all the tartar off so no need to floss. Does that sound right to you? It would save me a lot of time if it works that well.
Matt, you and I are almost neck and neck with treatment dates. I had my last rad on April 2, 2014. So, 2yrs/3mo. out. Does your mouth open up when you sleep? Do you think the Xylimelts will help with an open mouth with no saliva flowing?
Thanks to both of you for the tips.
Tom
Tommy, I've never been a lover of flossing with that all that thread junk. Actually couldn't ever get it wrapped around my fingers and try to do it correctly, and I'm sure some laziness was thrown in there too. To answer your question, the Water Pic won't get all the plaque and tartar from the surface of the teeth, but the time spent getting them cleaned by the hygentist seems to go by alot quicker than it was prior to using it. Within the last year, I only go every 6 months, but the four years right after I finished treatment, I went every four months. I'm still daily using the Floride trays with Colgate Gel-Kam, 3x daily brushing with Colgate Prevident 5000 for Dry Mouth, frequent Water Pic usage, and using periodically using "Brush Picks"......those thin plastic interdental toothpicks. Since treatment ended in June of 09, I've had one filling, and a fairly rough root canal on a back lower molar (which is still iffy to save). I'm doing my best to save my teeth, even though daily it seems that the rest of my body is falling apart
. Might not be able to lift the groceries out of the trunk......but I hope to have a pretty smile trying.Larry
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Duggie88 said:
Tom
As Don has stated a big issue is bacteria. The hygenist at my dentist told me I should use mouthwash. Listerine even came out with one with no alcohol that will not dry your mouth out especially at bedtime. I use that then use my special flouride touthpaste before bedtime. Hell even after all that my wife thinks I still have a dirty mouth.
Jeff
Jeff,
You do!
Matt
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UpdateCivilMatt said:Jeff,
You do!
Matt
Thanks All for your comments!
Saw my Oral Surgeon yesterday and we had a little chat. It just came down to whether or not the flouride trays do any good or not. The jury is still out on that subject. So I guess I'll just keep doing what I've been doing. He checked my teeth and said they were perfect. And no, he had no suggestions for any tool that would help keep my mouth closed while sleeping. We all agree that duct tape is still the best solution.
Once I got the flossing down right it only takes a few minutes to run through my mouth. If you want to keep your teeth, floss. Simple as that. I have to use the thicker strand because of all the years of doing it. That and a proxy brush gets most everything. When I travel I use Prevident instead of the flouride trays. Now that I know it's not as important with my teeth I won't worry about it.
Thanks again everyone for all the tips and advice,
Tom
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thankstommyodavey said:Update
Thanks All for your comments!
Saw my Oral Surgeon yesterday and we had a little chat. It just came down to whether or not the flouride trays do any good or not. The jury is still out on that subject. So I guess I'll just keep doing what I've been doing. He checked my teeth and said they were perfect. And no, he had no suggestions for any tool that would help keep my mouth closed while sleeping. We all agree that duct tape is still the best solution.
Once I got the flossing down right it only takes a few minutes to run through my mouth. If you want to keep your teeth, floss. Simple as that. I have to use the thicker strand because of all the years of doing it. That and a proxy brush gets most everything. When I travel I use Prevident instead of the flouride trays. Now that I know it's not as important with my teeth I won't worry about it.
Thanks again everyone for all the tips and advice,
Tom
Thanks for the update Tom. The chat with the OS kind of sums up the continuing debate over trays. I'm still in the "it can't hurt but does it work" camp. lol
Did you discuss the waterpik device? Beyond brushing this device is the single most effective tool for keeping all the bad stuff off the teeth and gums. I use plain warm water but wonder if using some other solution might be even more effective. But water along does an amazing job. Not only does the direct water jet blast out all food particles, it "powerwashes' all the teeth surfaces as well. There is a very noticable difference in the feeling of the teeth after using this thing. It may not remove plaque but I am sure it removes everything that promotes or feeds plaque.
Have you tried or bought one yet? For me it sure beats doing the flossing routine.
fyi - i am not a door to door waterpik solicitor. lol
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Water Picdonfoo said:thanks
Thanks for the update Tom. The chat with the OS kind of sums up the continuing debate over trays. I'm still in the "it can't hurt but does it work" camp. lol
Did you discuss the waterpik device? Beyond brushing this device is the single most effective tool for keeping all the bad stuff off the teeth and gums. I use plain warm water but wonder if using some other solution might be even more effective. But water along does an amazing job. Not only does the direct water jet blast out all food particles, it "powerwashes' all the teeth surfaces as well. There is a very noticable difference in the feeling of the teeth after using this thing. It may not remove plaque but I am sure it removes everything that promotes or feeds plaque.
Have you tried or bought one yet? For me it sure beats doing the flossing routine.
fyi - i am not a door to door waterpik solicitor. lol
Donfoo,
Yes, I have considered the waterpic several times over the years. I did forget to ask if it gets as much plaque off as flossing does. You and others say it does a better job. It would sure be easier on my teeth and gums than running them down with floss. Some people floss too hard and it cuts through the teeth. I am not one of those. Considering my teeth are as perfect as can be, I'm hesitant to change. Next visit I will ask which one is better. If it is even I think I'll switch to the waterpic to avoid the wear and tear of my teeth.
Thanks for the info,
Tom
0
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