I've just finished my 3rd week of radiaton, and by mouth has sores all over the place, tongue and cheek.

When my doctor examined these, he apologized and said he had been remiss in helping me prevent some of this from happening.

It seems that my metal fillings (I have quite a few) seem to reflect a tiny amount radiation back to my cheek, and the sides of my tongue (not cancerous) get some too.

This is his personal tool, not a medical device. He warms up some medical wax and molds it to fit around your teeth. Kinda like a denture. It doesn't block radiation. Friday, was the first day I used it. I'll see how effective it is as I go along. Anything will help as my mouth has grown quite painful.

Just like to pass on info that someone may find usefull

Sandyst

Sandy
my prothodontist had me wear my flouride trays during radiation for similar reasons, However, some posters here have questioned the science behind this as sketchy and they could be right, I do know that my fillings really skewed the CAT scans so only MRIs worked, and it comforted me so that was good enough,
Thanks for sharing
Charm

Most likely the idea is to get your skin away from the radiation beam. This is also why they insert cotton rolls to provide some separation (ie for lips etc). I had a tongue depressor to properly position and restrain the tongue with respect to the radiation field.... However, that needs to be done before/during the radiation planning.

Wax or plastic does NOT efficiently absorb xrays... If that really would work people would use plastic aprons etc and not use LEAD containers etc. Seen many bomb shelters with wax wands??

M

I can get more info to clear up any misinformation, but this is what my radation doctor told me.

The wax does not prevent the radiation from hitting it's target.
However, a very small residual radiation somehow pings off the metal to your cheek. It touches you cheek just enough to create a sore point. The wax will help prevent that occurance.

Concerning the tongue. Just assuming here, but since the tongue actually touches my teech, I think that the wax moves the tongue away to prevent sores.

I just hope it works.

If the radiation is just scattered i.e. it has the same (or very similar) energy as the incident radiation it will NOT be absorbed by the wax for exactly the same reason as the original radiation (x rays) was not.
On thing wax will do is to moderate neutrons that may be generated by high energy x rays ca > 8-10MeV). I am not sure what energy is currently used in IMRT of oral cancer... and if neutrons are even an issue here.

Re tongue: as long as your RO (and the person who actually calculated your map) knows this you should be ok. (you are moving an anatomical structure that is in the radiation field and that now gets a different dosage).

M

Markus: I'll try to get more precise informtion this week.
Sandyst

Sandy,
this is probably just academic. If you find out great, if not, no matter. It is not like there are that many options available anyway. (i.e. the rad plan must be completed even if things get more miserable which they most likely will). Of the other hand it IS just temporary, knowing this made thing more palatable (pardon the pun) for me. On the practical side, you want to watch out for thrush, that can make things a lot more miserable.
The generation of neutrons is something they are discussing these days for IMRT, largely because of the higher energies that are available. Besides being damaging all by themselves neutrons can also make certain elements radioactive (Silver and Mercury of fillings). The silver isotopes are very short lived. (We did this experiment in a physics class in the 80's using paraffin as a moderator. Anyway for a patient these are probably second order processes and not important... still interesting though in an abstract sort of way.

M

I had one metal filling in my mouth pre Tx and my dentist replaced it with ceramic due to the upcoming rad Tx's. May have helped but my mouth still became a disaster.

David: If I'm able to in the future, I'd like to replace my fillings. There was such a rush to get me into treatment in Janury that no one gave it a consideration.

I'm okay now. The sores have mostly healed which surprises me.
The only soreness I have now is my tongue. It is very uncomfortable.

Sandyst.