Posted By: Redser Dental care after brachytherapy - 01-31-2007 07:55 AM
I was reading some posts about the effects of radiation on teeth and I am looking for some advice on how to look after mine.

I had brachytherapy of the tongue for one week last April. Since then I have not had any problems with my teeth, other than slight itchyness on the side of my mouth where the cancer originated. My mouth itself is a bit dry, I cope with this by breathing mostly through my nose and carrying a water bottle everywhere. I also drink a lot of water with meals and like most people here stick to soft foods that are not spicy.

I floss daily and brush after every meal. I alternate between using an aloe vera toothpaste and Sensodyne toothpaste (for sensitive teeth). I was also using a non alcoholic mouthwash until I developed another ulcer last december. Now I just use water to rinse as anything else stings.

My last dental check up was in August. The dentist said everything was fine. I mentioned to him I had treatment involving radiation but he didn't seem to think this was going to affect my teeth. After reading some old posts about dental care I made another appointment for a month's time.

My questions:

1. How should I look after my teeth in general after the type of radiation I had (I am unsure how much the brachytherapy would have affected them, as compared to standard radiation treatments)

2.What sort of things should I ask the dentist to look out for or ask him to give me to use (I see from other posts that some people have been prescribed floride treatments)?

As I am living in Luxembourg, some brand names are different, so if you are recommending a specific product please mention what is in it, so I can explain to the dentist/pharmacist what I want.

Redser
Off to brush my teeth again....becoming a little paranoid!
Posted By: Cathy G Re: Dental care after brachytherapy - 01-31-2007 09:43 AM
Redser,

I had both conventional radiation and brachytherapy, and from what I've read here, the post-treatment dental regimen is about the same in either case. It's good that you're being diligent about brushing and flossing and keeping your mouth as moist as possible.

Dry mouth problems can set you up for dental issues because your mouth isn't routinely getting the full range of enzymes in normal saliva that help to keep your teeth and gums healthy. Many of us have been using Biotene mouthwash/gel/spray/toothpaste products, which are specifically designed to deal with these problems. (I'm not sure whether they're available in Europe.) Also, I've been using Salagen (generic name: oral pilocarpine) on a regular basis to boost my saliva production -- I know this works better for some people than others. Another medication for this purpose is Evoxac.

It's also important to get some extra fluoride protection going forward. This can be done with "trays" that are fitted to your teeth and are typically used to apply fluoride gel for 5-10 minutes at a time. Alternatively, you can get a prescription fluoride toothpaste that you brush onto your teeth (I try to do this once a day -- an electric toothbrush is especially good for this).

You probably will also need periodic teeth cleanings more frequently than you did before. It's pretty standard after radiation to need cleanings every 2-3 months because plaque can build up faster.

If you don't have a dentist who's trained to look for post-radiation problems, I'd suggest that you try to find one (as well as a periodontist you can see from time to time to check on the condition of your gums).

Cathy
Posted By: Redser Re: Dental care after brachytherapy - 01-31-2007 11:24 AM
Cathy,
Thanks for tips. I have seen Biotene before, in Ireland at least.

I am not sure what they call peridontists here - I went to see a stomatologist at one stage, that might be similar. Mind you he was the one that misdiagnosed me originally - told me I should stop fussing about the original ulcer and pain in the ear. I will have to do some research and find another.

Eilish
Posted By: Pete D Re: Dental care after brachytherapy - 02-02-2007 12:25 AM
Biotene makes a whole line of dry-mouth products, including a toothpaste (with fluoride), a "persistent" mouthwash (if I get up in the middle of the night, I take a sip of it and it covers the inside of my mouth to slow evaporation) and a sugarfree chewing gum (which stimulates some saliva for me).

My dentist prescribed a fluoride treatment -- Colgate makes one called PreviDent GEL (1.1% Sodium Fluoride) -- It can be used with fluoride trays made up by the dentist or applied with a toothbrush -- Either way, every day!

Finally, there is a prescription med named Evoxac (cevimeline HCL) which is also intended to stimulate saliva (haven't tried it), manufactured by Yamanouchi Pharma Tech in Norman, OK, USA.

Hope this list helps.

I also use one of the "sonic" style electric toothbrushes and I noticed that the dental hygineist has less work to do since I started using it (before all my cancer mess started).
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