Dental care
What is everyone doing, or been instructed to do for regular dental care at home? Upon finihsing my radiation and chemo treatments in 2018, the folks in the dentistry molded some trays and instructed me to use a 1.1% fluoride gel with the trays everyday for the rest of my life. They were renewing my prescription for the gel for a couple years, then said I needed to get the script from my dentist from then on. Everthing continued on as normal until I went on Medicare and a different prescription drug plan and started using a different pharmacy. I was recently notified by te prescription plan that the dental gel was not includedd in my plan or [insert some other reason] and to call them to straighten things out.
This got me to thinking whether the trays and gel are really necessary. My checkups every 3 months with my dentist are always excellent (and have been for many years) and when I asked him about just using a fluoride rinse when I go on a vacastion he said "You can skip any daily fluoride treatment for a week. It's not as though you're going to develop a bunch of cavities as a result". He also said that the 1.1% fluoride concentration is based on the worst cases (super dry mouth, bad teeth to begin with, etc). So he doesn't seem to completely fall in-line with the hospital dentistry department's strict guidelines.
I'd like to hear what type of regular home dental care others are doing, and if it was instructed as a post Tx regimen.
Comments
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Hello Romano
I can't say I was instructed in a particular way but was told by my cancer team that I had to be meticulous on my dental care from now onward and that before I started cancer treatment they wanted me to get a full dental exam and have my teeth up to the best level they could be. And have any extracted that needed to be pulled. I never got the trays that some talk about on here and they were never mentioned to me and it seems some cancer treatment teams recommend them and some don't. I go every 6 months for a cleaning and checkup and my dentist and hygenist are very aware of my cancer treatment and history and are very well up to speed on treating H&N patients and my dentist has at least several other H&N folks. They treat me wonderfully and are another group of folks that I can't praise enough for their good care. My dentist has prescribed Prevident 5000 to be applied each night before bedtime and it is just a toothpaste that has a higher fluoride count than regular toothpaste.
PreviDent is a prescription-strength toothpaste that combines the cleaning power of a toothpaste with prescription-strength fluoride. It helps restore the breakdown of enamel, prevents further decay, and aids plaque removal.
My hygenist has also recommended I use ACT Dry Mouth Mouthwash after brushing in the morning.
My hygenist has also recommended getting an electric tooth brush which I have done and the last visit she said there is a definite improvement.
I have recently had a checkup and had some areas that were suspect so although a bit early X-rays were taken just to be safe.
Also after cleaning and checkup, the dental hygenist applies a fluoride treatment that I pay an extra $30 dollars for that helps protect my teeth.So my regimen is--
Floss and brush in the morning and follow up with the ACT Dry Mouth Mouthwash.
Anytime eating thereafter I use one of those little between the teeth brushy things between my teeth and I brush my teeth.
At night before I go to bed I brush my teeth and rinse and then brush with the Prevident 5000 with prescription-strength fluoride and just spit out any excess I have or want to and not rinse. You are not supposed to rinse but leave it at strength in your mouth for protection.
Have a full dental cleaning and exam every 6 months.
Anything else my Dental Team recommends.Take care-God Bless-Russ
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My dentist just gave me
My dentist just gave me prescription strength fluoride toothpaste and said to keep up with dental hygiene. When my mouth got really bad, I started trying to pretty much drink everything because I didn't want to use my waterpik anymore because it hurts now.
Now that I'm using a tube I brush at least once a day just to try and freshen up a bit. I'm only one week out of treatment so I will add more back in as I feel better.
Right now just doing salt and baking soda water though and brushing with no paste because I can't tolerate anything minty. I couldn't even use biotene or the little foam toothbrushes. I have to use a toddler toothbrush because I have a small mouth. I couldn't use xylimelts too minty. Why does everything have to be cinnamon or minty? Ouch!
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Oh forgot to say I'm justozymandible said:My dentist just gave me
My dentist just gave me prescription strength fluoride toothpaste and said to keep up with dental hygiene. When my mouth got really bad, I started trying to pretty much drink everything because I didn't want to use my waterpik anymore because it hurts now.
Now that I'm using a tube I brush at least once a day just to try and freshen up a bit. I'm only one week out of treatment so I will add more back in as I feel better.
Right now just doing salt and baking soda water though and brushing with no paste because I can't tolerate anything minty. I couldn't even use biotene or the little foam toothbrushes. I have to use a toddler toothbrush because I have a small mouth. I couldn't use xylimelts too minty. Why does everything have to be cinnamon or minty? Ouch!
Oh forgot to say I'm just listening to my body instead of trying to strictly follow any kind of instructions. That always seems to
work better for me.
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ozy They Makeozymandible said:Oh forgot to say I'm just
Oh forgot to say I'm just listening to my body instead of trying to strictly follow any kind of instructions. That always seems to
work better for me.
Extremely soft brushes to be used at this point of treatment. Your cancer team should have one to give you, if not I guess the pharmacy would have them.
Take Care-God Bless-Russ0 -
Thank you Russ.
Thank you Russ.
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I'm rather fantaical aboutwbcgaruss said:Hello Romano
I can't say I was instructed in a particular way but was told by my cancer team that I had to be meticulous on my dental care from now onward and that before I started cancer treatment they wanted me to get a full dental exam and have my teeth up to the best level they could be. And have any extracted that needed to be pulled. I never got the trays that some talk about on here and they were never mentioned to me and it seems some cancer treatment teams recommend them and some don't. I go every 6 months for a cleaning and checkup and my dentist and hygenist are very aware of my cancer treatment and history and are very well up to speed on treating H&N patients and my dentist has at least several other H&N folks. They treat me wonderfully and are another group of folks that I can't praise enough for their good care. My dentist has prescribed Prevident 5000 to be applied each night before bedtime and it is just a toothpaste that has a higher fluoride count than regular toothpaste.
PreviDent is a prescription-strength toothpaste that combines the cleaning power of a toothpaste with prescription-strength fluoride. It helps restore the breakdown of enamel, prevents further decay, and aids plaque removal.
My hygenist has also recommended I use ACT Dry Mouth Mouthwash after brushing in the morning.
My hygenist has also recommended getting an electric tooth brush which I have done and the last visit she said there is a definite improvement.
I have recently had a checkup and had some areas that were suspect so although a bit early X-rays were taken just to be safe.
Also after cleaning and checkup, the dental hygenist applies a fluoride treatment that I pay an extra $30 dollars for that helps protect my teeth.So my regimen is--
Floss and brush in the morning and follow up with the ACT Dry Mouth Mouthwash.
Anytime eating thereafter I use one of those little between the teeth brushy things between my teeth and I brush my teeth.
At night before I go to bed I brush my teeth and rinse and then brush with the Prevident 5000 with prescription-strength fluoride and just spit out any excess I have or want to and not rinse. You are not supposed to rinse but leave it at strength in your mouth for protection.
Have a full dental cleaning and exam every 6 months.
Anything else my Dental Team recommends.Take care-God Bless-Russ
I'm rather fantaical about flossing and brushing, doing so after eating anything. Sometimes I just won't eat if I know it's going to be a few hours until I'm able to brush. I'm probably taking that a little too far. My team at Cleveland Clinic told me to have a dental checkup every 3 months, which I am. I didn't realize that ACT ame in a "dry mouth" formula. I'll have to look for that. But I just do the trays in the morning (after brushing, obviously) with the 1.1% fluoride gel and don't use ACT unless I can't use the gel. So it doesn't sound like we're too different in our regimens.
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Dental Care
I use the floride trays every night, after flossing, waterpik and brushing. I use the OralB Neutra Care gel, since it has a very mild mint flavor and I also have the very burning aversion to mint. I tried to switch to a children's toothpaste, but they never include sensitivity, so I suffer through the mint adult toothpaste. I think that I get the award for overkill. I would like to keep my teeth. In addition, in my first dental appointment after treatment my dentist filled four teeth, and the experience led to the return of trismus for a couple of days. I also had a tooth extracted earlier this year (2 years post treatment), and then started reading about ORN. It seems to have gone ok, since it was the opposite side of my treatment. I am supposed to get an implant to replace the back molar soon. I think a lot about dental care now.
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Dental Treatment
I too use the flouride gel but started buying it from Amazon instead of my dentists office. Also skipped to every other day 2 years ago and it hasn't made a difference. First sign of radiation decay and I'm back to every night. Some members have trouble and others do not. I've lost several teeth but not due to cavities. Just bone loss and receding gums. Going for my third bridge and an implant.
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over 12 years, and
I used the "special" toothpaste for maybe 6 months, then back the Crest Pro-Health. That was a long time ago. In restrospect, I have had the tops on 12 teeth rebuilt, so to speak, with Dentist putting something on top, and the front bottom more than once. And, I have noticed a tiny crack in one of my big two in front. Maybe I should have continued using. As for damage to the teeth- the lack of "good saliva" has probably impacted my teeth more than not using the sodium flouride paste. Maybe.
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Oral B Neutra Care isjerryob said:Dental Care
I use the floride trays every night, after flossing, waterpik and brushing. I use the OralB Neutra Care gel, since it has a very mild mint flavor and I also have the very burning aversion to mint. I tried to switch to a children's toothpaste, but they never include sensitivity, so I suffer through the mint adult toothpaste. I think that I get the award for overkill. I would like to keep my teeth. In addition, in my first dental appointment after treatment my dentist filled four teeth, and the experience led to the return of trismus for a couple of days. I also had a tooth extracted earlier this year (2 years post treatment), and then started reading about ORN. It seems to have gone ok, since it was the opposite side of my treatment. I am supposed to get an implant to replace the back molar soon. I think a lot about dental care now.
Oral B Neutra Care is prescription strength (1.1% fluoride). Does your insurance cover it? My insurance ia telling me that fluoride gel is not covered. If it's only around $10/month, I guess that's a small price to pay for avaoiding dental problems down the road.
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From what I can see, anytommyodavey said:Dental Treatment
I too use the flouride gel but started buying it from Amazon instead of my dentists office. Also skipped to every other day 2 years ago and it hasn't made a difference. First sign of radiation decay and I'm back to every night. Some members have trouble and others do not. I've lost several teeth but not due to cavities. Just bone loss and receding gums. Going for my third bridge and an implant.
From what I can see, any produxt on Amazon is 0.4% fluoride as opposed to 1.1% (prescription strength). As you say, some members have trouble, others do not. The dentistry department at Cleveland Clinic prescribed the 1.1% fluoride gel before I finished tretments, and I'm sure the reason is because of the lack of saliva that most patients experience. But I wonder if some patients, based on their dental health, and what percentage of their saliva function that returns, might not require that strength forever. I suppose they don't want to take that chance and simply prescribe the full srteength gel to everyone.
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The reason for using aLogan51 said:over 12 years, and
I used the "special" toothpaste for maybe 6 months, then back the Crest Pro-Health. That was a long time ago. In restrospect, I have had the tops on 12 teeth rebuilt, so to speak, with Dentist putting something on top, and the front bottom more than once. And, I have noticed a tiny crack in one of my big two in front. Maybe I should have continued using. As for damage to the teeth- the lack of "good saliva" has probably impacted my teeth more than not using the sodium flouride paste. Maybe.
The reason for using a prescription strength gel is because of the lack of good saliva. But it probably won't prevent all dental issues.
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Well I FiggeredERomanO said:The reason for using a
The reason for using a prescription strength gel is because of the lack of good saliva. But it probably won't prevent all dental issues.
It is just to prevent cavities but found this info "PreviDent is a prescription-strength toothpaste that combines the cleaning power of a toothpaste with prescription-strength fluoride. It helps restore the breakdown of enamel, prevents further decay, and aids plaque removal.
So these protective kinds of toothpaste do a little more than just cavity protection but with diminished saliva and the unbalances of the proper health ingredients of the proper saliva in the mouth it can cause problems over time. I figger even doing the extra dental care less saliva will eventually catch up with and cause tooth problems and probably tooth loss to some extent. I think we are doing the right thing and extending our tooth and mouth health for as long as possible.
Take care-God Bless-Russ
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Dental CareERomanO said:Oral B Neutra Care is
Oral B Neutra Care is prescription strength (1.1% fluoride). Does your insurance cover it? My insurance ia telling me that fluoride gel is not covered. If it's only around $10/month, I guess that's a small price to pay for avaoiding dental problems down the road.
My insurance does not cover presciibed dental gel, but the brand the pharmacies always seem to carry does not agree with me. My dentist carries the Oral B Neutra Care, so I just submit the reimbursement from my HRA.
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Dental CareERomanO said:Oral B Neutra Care is
Oral B Neutra Care is prescription strength (1.1% fluoride). Does your insurance cover it? My insurance ia telling me that fluoride gel is not covered. If it's only around $10/month, I guess that's a small price to pay for avaoiding dental problems down the road.
You may have to make sure that they know there is a medical reason for the prescription for the HRA to cover it.
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I Don't Think It Isjerryob said:Dental Care
You may have to make sure that they know there is a medical reason for the prescription for the HRA to cover it.
Covered by most insurances. (Denta 5000 and others)
So I just buy it, only $10 or $12 bucks a tube and it lasts a month or a little more.
Basically 2-3 bucks a week to help your teeth last longer and prevent cavities and wear.
With this product, a little goes a long way.Take care-God Bless-Russ
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Great Topic for many of us
ERomanO,
I was told that I would need to do daily Fluoride treatments for the rest of my life if I wished to keep the teeth I had at the time of my cancer in 2004. Base of Tongue cancer, Surgery to remove part of my tongue, Radical Neck Disection followed by 30 Radiation treatments that left me with no Saliva what-so-ever.
I was instructed to use the Fluoride Trays that cost $400 at the time. I did so each day and found it was troublesome at times as I tried to have a set time to do it. I later learned to just do it once a day just before taking a shower. Let the trays sit for 10 minutes in my mouth while showering, remove when done and let the Fluoride sit on my teeth for another 30 minutes before rinsing. I did this for 5 years using the trays. The Dentist moved on and at the same time, I started using the VA Hospital's Dental Department.
VA Dentist took me off of the Fluoride that the original Dentist had me use because it made my teeth very brown looking. I forget the name of the Fluoride at this time. I was given Colgate Previ-Dent, Fresh Mint and told to brush the Gel on after brushing my teeth. Let the Fluoride sit for the 30 minutes and rinse like before. It has been 16 years now and I seldom miss a daily routine. I did have 2 teeth break on me and that was my fault basically. I ate something hard and they cracked, the VA Dentist then capped them so I got lucky there. I also over time had maybe 2 or 3 tiny cavities over these years. I know we are supposed to stay away from sugar, etc. But I am making up for lost time of not tasting chocolate
. I looked at the price of the 1.1 % Fluoride. If you use "Good Rx" Coupons, you can get it for roughly $10 or less at you local Drug Stores. I am lucky as the VA sends it to me. As Russ mentoned, a little goes a long way, I use about a pea sized dab on my tooth brush to coat my teeth.
You brought up a good question about the amount of saliva each person may regain and how the Fluoride may not be needed as much. The VA Dentist told me the patients receiving Radiation and not having good saliva can get a cavity(s) in about 6 weeks. A normal person with saliva not taking care of their teeth will get a cavity generally after 6 months. I hope to keep the teeth I have and do not want to do the Hyper-Baric chamber dives if I can help it.
My Best to You and Everyone Here
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I also use the prescribed gel
I also use the prescribed gel, but my dentist is also a cancer vet, and very aware of my situation. She does a full floride treatment thingy on mine every six months. After five years post, certified this month, I show no signs of enamel decay. I have light-to-moderate drymouth, depending on the day. The main change I have done is avoiding processed sugars. No sugared gum, no mints, etc. During the day it's Xylimelts, period.
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