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#3111 07-26-2004 02:25 AM
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After one week of IMRT centered around my tongue and neck, I had felt blessed with no side effects, yet. That was until last night before bed my lower gums in front started to bleed after gentle brushing. Now that I think about it, the skin just below my upper lip is already showing some redness.

Am I being hypersensitive or should I plan on loosing my lower front teeth as a result of the radiation? The mind plays tricks, sometimes.

I know it's a little thing, but y'all are the only ones I can ask and get an intelligent, unbiased reply.


T1N0M0 Partial Glossectomy 2/04, Recurrance w/ another P.G. 5/04. IMRTx33 7/04-9/04. T2N2M0 recurrance in throat, 11/04.
2nd tumor 1/06/05, Chemo 1/11-05 Died 02-16-05 Wife: Brenda
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David,

I have not heard of seeing issues like yours so soon after starting treatment. Was there a dentist on your medical team that examined and xrayed your teeth before you started treatment? Did you have any PET/CT scans or CT with contrast prior to treatment?

I know of several people that have experienced minor gum bleeding during radiation but after several weeks of treatement.

I am not a dentist but I would suggest you see one to ease your mind.

Ed


SCC Stage IV, BOT, T2N2bM0
Cisplatin/5FU x 3, 40 days radiation
Diagnosis 07/21/03 tx completed 10/08/03
Post Radiation Lower Motor Neuron Syndrome 3/08.
Cervical Spinal Stenosis 01/11
Cervical Myelitis 09/12
Thoracic Paraplegia 10/12
Dysautonomia 11/12
Hospice care 09/12-01/13.
COPD 01/14
Intermittent CHF 6/15
Feeding tube NPO 03/16
VFI 12/2016
ORN 12/2017
Cardiac Event 06/2018
Bilateral VFI 01/2021
Thoracotomy Bilobectomy 01/2022
Bilateral VFI 05/2022
Total Laryngectomy 01/2023
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Ed,

Dental health is good. Saw a dentist the Friday before radiation started. Also had a CT w/ contrast and PET a few weeks ago; both were clean.

Can't think of any extenuating circumstances that would contribute to early bleeding.

Thanks for the quick response!


T1N0M0 Partial Glossectomy 2/04, Recurrance w/ another P.G. 5/04. IMRTx33 7/04-9/04. T2N2M0 recurrance in throat, 11/04.
2nd tumor 1/06/05, Chemo 1/11-05 Died 02-16-05 Wife: Brenda
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David,
When my husband started radiation, I bought him the softest baby toothbrush I could find. Are you using something like this? At 16 months post radiation, he still uses his Donald Duck toothbrush.

Good luck with your radiation. It is a rough road, but things get better.

Anita


Husband Dx 12/02 Stage 4 Tonsil Cancer T1N2bM0; surgery, radiation, chemo 1/03 - 4/03.
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If you have good teeth radiation will not cause them to fall out. It does make for problems if, down the road, they do. Point it out to your Radiation MD and get a super soft brush. Gentle brushing has now taken on a new meaning.

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Hi David,
I did have some minor bleeding and some white "spots" on my gums on my 7th day of radiation. I will never forget that day as it sent me into a tailspin with the white stuff, I thought for sure it was the cancer coming back. I RAN to my radiation center to find it was the beginnings of mucocitis and that my gums were going to have a rough go with the radiation treatment. Good luck with the rest of treatment and holler to us if you need us.
Minnie


SCC Left Mandible. Jaw replaced with bone from leg. Neck disection, 37 radiation treatments. Recurrence 8-28-07, stage 2, tongue. One third of tongue removed 10-4-07. 5-23-08 chemo started for tumor behind swallowing passage, Our good friend and much loved OCF member Minnie has been lost to the disease (RIP 10-29-08). We will all miss her greatly.
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Thanks to all! Your responses have eased my mind already. I will mention it this afternoon during my session, though. My wife, Brenda, got a real kick out of the "Donald Duck" toothbrush, Anita. Now, you've gone and done it! She'll probably be getting "fun" things for me to use, too.


T1N0M0 Partial Glossectomy 2/04, Recurrance w/ another P.G. 5/04. IMRTx33 7/04-9/04. T2N2M0 recurrance in throat, 11/04.
2nd tumor 1/06/05, Chemo 1/11-05 Died 02-16-05 Wife: Brenda
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David,

Has anyone mentioned flouride trays to you? If not, you'll want to look into this as it will become part of your "new normal." On of the side effects of the radiation is either decreased syliva production or decreased quality of syliva or both. As my dental oncologist explained it to me, syliva is 90% water and the other 10% consists of numerous compounds -- some of which help protect our teeth. As result of the interrupted syliva function, dental carries are another after effect of radiation. To counter this problem, he perscribed dental trays (similar to teeth protectors worn when playing sports) to be loaded with gelled flouride and worn every night for at least 10 minutes after brushing.

If you haven't already, you definately want to look into this.

-Brett


Base of Tongue SCC. Stage IV, T1N2bM0. Diagnosed 25 July 2003.
Treated with 6 weeks induction chemo -- Taxol & Carboplatin once a week followed with 30 fractions IMRT, 10 fields per fraction over 6 more weeks. Recurrence October 2005.
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At 16 months I finally retired my baby toothbrush (my wife got me one with a teddy bear on it) and went back to the Sonicare.

One week does seem a little early for these kinds of problems however. I don't recall ever having gum bleeding even during the worst phase.

I got "longer in the tooth" as a result of some gum loss but they held up pretty well. IMRT is the least of the evils for harshness on the gums. More surprising is that it's in your front teeth - typically the teeth most exposed to the radiation take the brunt such as the molars. I would get to a dentist or dental oncologist and have it checked out.

By your comment that your dental health is good I take it that you are free of gum disease as well?

If you are not flossing carefully you can easily cut the gums as well. I used a Waterpik during the worst part of treatment.

I wouldn't plan on loosing any teeth - I still have ALL of mine - I wouldn't let them pull any out.

You must be willing to go the distance however, dental trays, flouride treatments, frequent cleanings, floss, WaterPiks, etc.


Gary Allsebrook
***********************************
Dx 11/22/02, SCC, 6 x 3 cm Polypoid tumor, rt tonsil, Stage III/IVA, T3N0M0 G1/2
Tx 1/28/03 - 3/19/03, Cisplatin ct x2, IMRT, bilateral, with boost, x35(69.96Gy)
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Actually, Colegate now makes an ultra-soft brush in the "standard" appearance. This would be useful if you would prefer a more dignified and mature brushing experience.

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This is from a prior post:

My social worker also recommended brushing with devices looking like "sponges on coffee stirrers". For some reason, I thought I read about it here too. Coincidentally, yet another advisor recommended them yesterday and emailed me:

Sponge Swabs:
Toothettes by Sage Products, Inc. 1.800.323.2220 manufactures the toothette.
You can go to their site and click on Clinical Products and Oral care...www.sageproducts.com

Sabrina

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I needed those swabs for the middle to latter part of my radiation treatment. Even soft toothbrushes felt too harsh at that point, and I used the swabs followed by some VERY careful flossing.

Cathy


Tongue SCC (T2M0N0), poorly differentiated, diagnosed 3/89, partial glossectomy and neck dissection 4/89, radiation from early June to late August 1989
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With flouride trays in hand and Biotene mouthwash and toothpaste at the ready I thank you for your comments, advice and experience. I'm prepared for a kinder, gentler, yet dignified approach.


T1N0M0 Partial Glossectomy 2/04, Recurrance w/ another P.G. 5/04. IMRTx33 7/04-9/04. T2N2M0 recurrance in throat, 11/04.
2nd tumor 1/06/05, Chemo 1/11-05 Died 02-16-05 Wife: Brenda
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OCF is about ready to take delivery on some VERY VERY soft tooth brushes to use during the worst part of it all, and while I don't have them all in hand right now ready to put up in the OCF store online, I can send you the few samples that I have ( sterile in the bags still). Just email me your adress and I will see that you get them.


Brian, stage 4 oral cancer survivor. OCF Founder and Director. The first responsibility of a leader is to define reality. The last is to say thank you. In between, the leader is a servant.
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