Hi, my husband is going to get the radiation and chemo treatment soon for the cancer at the base of his tongue. Many of you who went through the treatment talked about the various dental care stuff for use during and after the treatment. I also read some people said that they wish they had used certain dental care stuff so as not to have the suffering as they experience now. I'd like to ask for a list of the dental care we should prepare for the treatment. My husband doctor mentioned a couple of solutions he should use. But it seems there are many more stuff we need to get. Thank you for your help.

Yan

Hello Yan, My dentist "sealed" the wear surfaces of my teeth before I started treatment. In addition, floride treatments help. His dentist should be able to advise him about which brand of floride product may suit him better. Some here use trays for the floride treatment and do it quite frequently. Weekly floride treatment should be ok. I do one once a month. Brushing should be done 3 or more times a day.

Hello

When brusing got painful and the RT created lesions on my tounge I used childrens milk teeth toothpaste, had the all the benefits and non of the pain!

Here's a list for you:

1. Biotene toothpaste (most stores have this)
2. Baby's toothbrush (easier on the gums)
3. WaterPik
4. Custom flouride trays (about 200+ bucks from your dentists)
5. Ask them for prescription strength flouride foam to go with them (far superior to OTC stuff)
6. Biotene mouthwash (do NOT use mouthwash with alcohol in it)
7. Yarn type dental floss - easier on the gums - this stuff is harder to find but usually drug stores have it - it has a candy cane logo on the container (J&J)

When I got to the point during radiation that I couldn't even tolerate a baby toothbrush, my nurses gave me little sponge-type swabs to help work the toothpaste around (which I then followed with flossing).

Cathy

What Gary and Cathy said applys. I had no dental problems. I used the trays every night with floride.

Steve

Regarding the ultra soft toothbrush for the most difficult period in the middle of treatments when the mucocitis is at its worst, the Laclede/Biotene web site has an adult size Ultra/ultra soft one for sale. I started out with the softest ones from the drug stores, changed to this Laclede brush when it was really tender in there, and then went back to the ultra soft drug store version towards the end. It goes without saying that during this period of time, I didn't care about my mouth that much since I was in so much pain...but no matter how disinterested or painful, patients HAVE to keep up their hygiene during this period of high risk for periodontal disease and caries. I would add to the list pf Gary's Biotene's Oral Balance gel to smear on the soft tissues during the night so they don't dry out, particularly if there is mouth breathing involved. The Biotene mouthwash was also helpful during the days, as it has glycerin in it and that helped keep things bearable. Least I sound too much like and advertisement for their products, the lack of SLS that is an irritating detergent in their toothpastes, and the lack of extremely strong flavors that burn really made a difference. Also worth having on hand, baking soda and salt for rinses to help with healing and cutting the mucous. As the doctors for some kind of lidocaine mouth rinse for when things really get sore. Variously known as

I had some personal emails about the flouride foam. There are two that I know of: Butler 0.9% (pH) Neutral Flouride Topical Foam and one by Oral B. Note that these are prescriptive and you can only get them through your dentist. I tried the Oral b at the dentist office and I am going to switch to that when my can runs out. The foam is great, you use very little and it stays in place. You can get many different flavors as well.

From what I have heard, these are clearly superior to any OTC stuff. The pH neutral is very gentle on the tissues. It's a 5 minute treatment.

I am very grateful for the help you offered to me. Last night after I sent the message, I surfed the postings. Some people mentioned using drugs for dry mouth problem. I am wondering whether there are other dental problems besides the dental care we sould prepare. Thanks again for your help.

Yan

ph neutral also does not etch the surface of your teeth... or porcelain crowns.

Your support staff and doctors will hopefully prep you for much ahead of time. I think it was gary who posted a really good list of things to have on hand before you needed them, but I can't find it now. it dealt with things like pain meds before they were needed, laxatives, which the pain meds will cause you to need, and much more. Gary if you read this, could you put up your "get ready list" again?

Well the original post was a request for dental information but here's the rest of the stuff you should have "pre-positioned". If you really need these and you don't have them on hand - you will be making a trip to the ER to get them, which usually always seems to happen either at night or on the weekend.

1. Anti-emetics - several different ones and compazine suppositories are a great idea as well.

2. Anti-acids, like Pepcid AC

3. Laxatives and stool softeners like Colace

4. Thrush medications like Diflucan and/or Nystatin "swish & spit"

5. "Pink Magic" a compound mixed by the pharmacist with morphine and lidocaine for numbing the mouth - essential for eating and drinking orally with mouth sores

6. Narcotics - long term and short term
- "long" for everday pain such as Duragesic patches or Oxycontin
- "short" for breakthrough pain such as morphine sulphate.

7. Topical lotions for radiation burns like "Radiacare" - some RT departments have samples of this they will give you.

Insure the skin is dry and clear of all lotions before actually receiving your daily RT. Some lotions can have a "bolus" effect where they actually enhance the skin damage.

I don't know if this was mentioned to you or not yet, but getting fitted for dental protection trays is also important before you start treatment. Was a peg tube also mentioned? I waited to long because of stupidity and almost died of dehydration over a weekend. DON'T wait get it done prior to feeling exhausted and in pain. Maria G

New here (ok, returning from a few years ago)...

my Mother in law (lives with us) was just diagnosed with her 2nd round of oral cancer.. first time was 6 yrs ago on the top of her mouth/sinus area. It took nearly 3 yrs to get her dental implants to the point where she could begin to think about eating something other than boost when she was diagnosed with esophageal cancer (another primary). Just today she was diagnosed again with oral, this time near the corner of her lip. Frankly, her mouth has been a mess for a few years now, she is tube fed and has been for 3 yrs and is so fed up with it all.

We are waiting now on her appt with the radiology oncologist (her ENT does not think surgery is a good option for her at this point, especially given the condition of her mouth already). In the meantime, I am trying to get my ducks in order... would getting her seen asap by her prosthodontist be the next step? Her lower implants are screwed in semi-permanently, and the uppers she can remove on her own.

Because I have a special needs child I really have to plan ahead as much as possible. He is TPN and GT fed and we have to travel for his medical care at least a few times a year (coming up the end of october through mid november), so planning is essential to make sure everyone is taken care of appropriately.

Any suggestions on planning would be most helpful... I do have a call in to her regular onco doc as well, hoping maybe he can give us some insight on what this means and what to expect with regards to how well he expects her to get through treatment, assuming she decides to. She is considering not, so if you can give thoughts regarding what would happen if she chooses not to treat that would also be appreciated..

thanks a bunch,

heidi

Dear Heidi, what a challenge for your family! While I can't speak to the issues above[other than appreciate your mother-in-law wanting to be able to make her own choice]I do hope the best for you all. Amy