Gary--

I recall what our denatal oncologist said when we met him prior to Barry's treatment -- "we never pull a tooth without just cause..." -- he said that "in the old days" (his words) "we used to pull lots of teeth before radiation but now we can prepare them better beforehand and also, we have more precise delivery of radiation AND better approaches for improving salivary function after treatment. He is a big fan of amifostine and of Evoxac. Last December he told us he had subitted a paper on radiation effects on oral and dental health to Lancet, but that they had "better print it soon" as things were changing fast enough so that it might soon be out-dated.

I know he told Barry that the tomoTherapy radiation field for his particular treatment plan (he had tonsillar and base-of-tongue, + two nodes) did not significantly impact his anterior oral cavity and only the very back teeth on one side got much radiation (and that not the full 66 Gy dose). Still, he did warn that serious dental work needed to be done by a oral surgeon experienced with radiation patients and might (depending on where in mouth) involve HBO treatment.

The gum he recommends is one of the brands which contain Xylitol and are made especially for dental hygiene. Ask your dentist about this...

Gail