Tooth decay

I am a little over 4 months post rads and have had one dental checkup that was fine. My dentist coincidentally has 13 years experience with HNC patients at the VA hospital in Tucson, Az. He put me on a strict regimen even before treatments began. Basically, it is this:

**Get Biotine mouthwash. He sells it to me in 1-gallon pump containers for $30. I used one gallon in the first 2-3 months which included treatments. Now I am using it about a 1 gallon every 3-4 month rate. I rinse and spit with it frequently. There is no limit to the number of times a day you can use it. During treatments I used it probably 5-10 times a day and during the night. It's taste is not bad and it actually makes my throat and mouth seem more moist. Use it especially after brushing to kill any stirred up bacteria.

**Brush after every meal, use the Biotene. I use an electric Oral-B toothbrush and "extra" brush sensitive areas along the gumline when they come up. If I do that usually they dissappear within a few days. It has worked very well for me.

**I know that you MLC53 are post rads, but for others just starting or about to, during treatments I used Miracle Mouthwash and Walgreen's Ulcerease. The Ulcerease slightly deadens sore spots long enough to brush them but I used the softest brush I could find. The MMW helps prevent Thrush which also is a major oral hygiene issue. My dentist also had me rinse/spit several times a day with a glass of hot water with 1/4 tsp. baking soda and 1/8 tsp. salt. This helps to regulate the PH in your mouth which affects bacteria production.

**Everything that was in the field of radiation will never be the same in terms of healing capability. For example, I accidentally bit my tongue and it has taken 2-3 weeks for it to improve. Prior to radiation it would take a day or two. So, all that to say, FOCUS FOCUS FOCUS on oral hygiene and dental care.

MLC53 said:

thanks for the detailed explanation and the tips!

With the dry mouth condition, my teeth would rot more frequently. The dentist was repairing my teeth about twice a year. Most of the decay would be in the area on the base of the tooth, by the gum area.

Finally, my dentist recommended that I brush using the prescription tooth paste Denta 500 plus (fluoride toothpaste). He also recommended that I rinse each night before going to bed with the rinse called "ACT" (a fluoride rinse). I have been doing this for seven years and have lost only one tooth since being treated for cancer 10 years ago. I also have my teeth cleaned at least three times a year. I believe we have tooth decay under control. I also brush after every meal if I am at home. Good luck!

MLC53 said:

thanks for the detailed explanation and the tips!

I've had problems with dry mouth for years because of radiation. One of my salivery glands "died". My dentist has experience with cancer patients so I've been able to keep my teeth for a long time.

To add to what jkinobay said, I have my teeth cleaned every four months. I use a prescribed toothpaste but can't remember the name right now (your dentist would know). Biotene is a good product for dry mouth but I do not use it's toothpaste. I use Biotin gum during the day if my mouth feels too dry. Gum is sugarless, helps with a dry mouth and doesn't stick to dentures, if you have them. I also have water available all the time. Brushing your teeth at night and flossing helps, plus the rinse (there are several types). Biotin also has a gel that you spread on your tongue and helps with the dryness. Sometimes I use it on my tongue after brushing and flossing.

My dentist also made a plastic thing like those used to make a mold of your teeth. It is light plastic and was made to fit my teeth. After brushing teeth at night, I apply a prescribed gel on it and then put it on top of my teeth for about 10 minutes.

I still have teeth thanks to my dentist.

MCL, I'm >7 years out from stage 4 HNC and had >70 gy radiation in the H&N. I've not had a single cavity since treatment ended. My rad onc is really aggressive, and insistent his patients get back a quality of life worth living. He's adamant that I use fluoride trays each day. The trays are molded by a dentist (cost about $100) and a small ribbon of prescription fluoride squeezed into the trays each night before bed (my prescription is for Colgate PreviDent Gel (1.1% Sodium Fluoride)). You'll wear your trays for 10 - 30 minutes before bed. I use a SoniCare toothbrush which does an amazing job of cleaning and also stimulates blood flow in the gums (which is critical to good oral health). I also floss like crazy each day. I suffer from chronic xerostomia but, in spite of the challenges that presents, my teeth have been perfect. I can tell you from personal experience this regimen works!

stevelfun said:

What I do
I have flouride trays. You 'can' sleep with them in. I will sometime where them on the commute to work.

Sugarless chewing gum with xylol (sp?) helps stimulate saliva.

Some use sugarless candies, but I don't much care for them.

I carry around a small runners water bottle (6 oz) to sip on.

Floss, water pick, brush, rinse with Biotene's mouthwash.

There are drugs that seem to help some with the production of saliva (pilocarpine) didn't help me much. I heard about another one here that I will ask my docs about (Evoxac).

All these things will help.

tooth decsay and gum regeneration
I believe my wife bought me something called "Act" mouthwash which has a pretty good job at helping my gums regenerate tissue. I've actually noticed the gums staring to grow back into the spaces between the teeth.
My ENT has some kind of pink potion mixed up for my sores he calls it a miracle mystery mouthwash and it numbs my tongue before I eat allowing me to eat with less pain. Like another poster stated, get used to soft sandwiches with a bowl of soup! The soup really helps.

MArk

Tooth Decay
Same thing happened to me my docors gave me fluoride trays 2 use at night and a fluoride tooth paste to use in the morning also brushing after every meal, staying away from soda and stuff like that.

i have a question for you do you wake up at night really thirsty sometimes gagging and if so do you know anything to help this

soccerfreaks said:

gagging and thirst
I would recommend a few things. I am assuming that the gagging is caused by phlegm building up during the night. I am not aware of how long you have been at this, but this was especially prominent for me right after the surgery, and during the rads and chemo, and seemed to last for close to a year.

What helped me was using an anti-dry-mouth mouthwash before going to bed, then have a small gargle of water to expel any remaining phlegm, and then also having a small bottle or glass of water by my bed, so that if I did get up with dryness and thirst, I could have a quick shot of water and go back to sleep.

I will advise, again, that the plague of nightmare phlegm did not go way immediately.

It is, though, I can assure, no longer even a concern of mine. I am now three years away from the surgery, and 2.5 years away from the end of the rads and chemo for the tongue/neck cancer treatement I had.

I still have to expel the stuff during the day from time to time, but you learn to handle that with tact. For example, if you are in your kitchen and there are people there that you wish would go home, you do it in front of them and make a spectacle of it .

Otherwise, you keep cups in the bathroom and take care of it as you need to.

It does become less frequent, I assure you.

Take care, and best wishes.

Hope and Humor!

Joe

thx
thx for the advice i will deff try the mouthwash b4 bed the gagging is actually cause by the dry mouth and only a cold drink stops it like warm water wont help but maybe the mouthwash will
thx - Kar

Saving those Pearly whites!!
My husband is a dentist and he has done a great job of helping me keep on top of these teeth to delay any decay that can happen from lack of saliva. I have always been prone to cavities so my husband was especially worried without the saliva. ENT comments on at every appointment how remarkable my teeth are and they haven't shown any further decay in 4+ years without saliva.

During treatments - I used a BIOTENE MOUTHWASH. I used a lot of MAGIC MOUTHWASH and some of it was very syrupy sticky and I worried it would cause dental issues too so a short while after using the magic mouthwash I would use a VERY SOFT TOOTHBRUSH(got from dentist) with biotene tooothpaste or even just plain water. I BRUSHed AFTER EVERY MEAL during treatments too and then followed with the rinse. I also had Thrush a lot during treatments so would have to do a lot of SAL WATER RINSES(which burned!) My husband (dentist) also made me FLOURIDE TRAYS out of a soft plastic and cut them down so as not to give much irritation to the gums. I wore these flouride trays to the radiation treatments and they allow radiation still to get where it needs to but it cuts down on the "bouncing" effect of radiation giving excess mouth burns you can get from lots of metal fillings in your teeth. Then I would use these flouride trays faithfully, every night (supposed to do it for 15 minutes but some nights would only do about 5). You put flouride paste (I used PREVIDENT GEL 1.1%, prescription) in the tray and put it over your teeth. It's very similar to the bleaching trays you see people use. Don't rinse with any water after using the trays to allow the flouride to "sink in" and do its job.

Now, after treatments:
I BRUSH AFTER EVERY MEAL, and still occasionally use the Biotene MOUTHWASH. I also brush beyond the teeth and get the gums too. A softer tootbrush works good but not as soft as the one I used during treatments.

I FLOSS every night and still use FLOURIDE TRAYS with Prevident gel in them for 10 minutes. If I am totally wiped out and can't think about staying awake another minute to do these trays, I will occasionally put a huge blob of the Prevident gel on a toothbrush and brush (really good) with it instead of toothpaste. Never rinse with water after using the flouride trays/paste since it'll just wash off the flouride and does no good then.If I am not at a place where I can stop to brush, I rinse with water, chew ORBIT CHEWING GUM (I use sweet mint flavor, less burn with it) for a minute or 2, then get rid of the gum. Then I use a "BRUSH PICK" and go between all the teeth (it's tiny like a toothpick). I keep these brush picks and the gum in my purse and in my car just in case I can't brush.

I get more FREQUENT PROFESSIONAL DENTAL CLEANINGS at hubby's office (every 3 months). He also has "varnished" my teeth with FLOURIDE VARNISH. They use it for little kids and it works great at preventing cavities, so even though I probably don't need it since I use the flouride trays, we give it the overkill and do the flouride varnish too.

Sideline on bleaching:
My husband also doesn't want me to use bleaching trays nor to bleach my teeth. He has seen some research showing that the bleach deprives the area of oxygen and cancer cells thrive when the oxygen is depleted in the mouth. So if there were some sneaky little cancer cell that managed to survive the radiation hell it was put through, he is afraid we'd help that nast little cancer out by bleaching and it might come back so he doesn't want me to bleach.

It all sound a bit meticulous but it's working!!