I have just returned from having impressions made for the fluoride trays I will use for the rest of my life. I would not have known to have these made if not for this board and other information on this site. I am sure that if asked, the several medical providers I have been bouncing between would say they thought someone else had told me about this. This is just one more example of the service provided here. Thank you Brian, and all others who post!

Joanna

Hi, please tell me about these flouride trays and what their function is. I can relay this to my sister. Thank you

Eli,

I'll try to answer as best I can - I am familiar with the trays-I have mine. But, my answer won't be real technical.

Before beginning radiation your doctor should insist you see a dentist. My radiation oncologist sent me directly to the oral surgeon. Radiation to the mouth has the potential to kill the salivary glands. It this happens you become very prone to tooth decay. (the moisture aids in keeping placque from forning.) Since you don't have salivary glands anymore, you run the risk of fracturing jaw bones with any major dental work after radiation. Any dental work that has to be done - you have to be treated in a hyperberic chamber first.
They will fit you for flouride trays and give you a flouride toothpaste 1.1%. I am on teeth cleaning every 3 months. Although I will say that I have not been able to use the trays yet after radiation, due to the fact the flouride burns my throat. I am told this will get better. The flossing and toothpaste is helping keep my teeth healthy. I now brush 2-3 times a day.
They wanted to pull all my teeth and we made the decision that I couldn't try and maintain my weight with no teeth. For me it was the right decision to only lose 14 teeth. My dentist tells me due to really good care for the past 7 months, I have stopped the progress of gum desease. It just takes determination and developing new habits.

I'm sure there is something I forgot to tell you and someone will come along that can supply you with more information.

Take care,
Dinah

The flouride trays are a must. The teeth can literally rot out of a person's mouth after radiation. Another board I am on just had a post from someone who is experiencing that because no one told him about the need for flouride.
Like Dinah I couldn't use mine right away because my mouth was too sore. In the meantime I brushed with a foam brush and used various oral rinses and a baking soda solution. I've been using the flouride for about 8 months now and thankfully my teeth seem to be in good shape. My dentist has had other patients who have had radiation and he is very familiar with the special concerns. Excellent dental care is very important post radiation. I also have a very skilled and patient hygenist who can deal with my inability to open my mouth very wide.

Fluoride is a must for the rest of your life after radiation treatments, and xerostomia. Check out the oral complications page in the dental section of the web site for more on radiation induced caries. This can be a serious problem, and it is related to the lack of saliva, not actually the radiation itself.

Without the enzymes and other protective agents in saliva, you are extremely susceptible to tooth decay. Fluoride is your best defense against it. Please note that tooth decay that gets bad enough to cause the loss of a tooth, is a more serious problem than losing that particular tooth. Radiated patients who lose teeth due to decay or periodontal disease (gum disease from poor hygiene) bear the risk of osteoradionecrosis. This can have dire consequences, and even cause a patient to eventually lose part of the mandible or maxilla if it gets out of hand.

Saliva contains hundreds of proteins and other chemicals with a wide array of properties. Among them:

* Mucins, proteins that make saliva stringy, protecting the teeth and gums and fighting bacteria. * Histatins, lactoferrin, lyzozyme and peroxidase, proteins that appear to fight bacteria and yeast. * Proline-rich proteins that allow large amounts of calcium phosphate to exist in our saliva--preventing our tooth enamel from dissolving. * Amylase, an enzyme that breaks starch into sugars and begins digestion of food before it reaches the stomach. * Chemicals such as epidermal growth factor and one called SLPI (or "slippy"') that aid in wound healing. * Hormones and drugs that reveal much about our physiology, making spit useful in crime and medicine.

You can see that without it, and it's decay preventative nature, fluoride becomes a necessity.

I've just had my fluoride trays made and was told by my dentist to wear them (with out the fluoride in) during my radiation treatments. He said that having the extra layer in my mouth will help to lessen the radiation damage to the inside of my mouth. Was anyone else advised to do this? I haven't seen my radiologist since given this advice, so I'm curious to see how accurate it is.

Thanks

Nettypoho, I seriously doubt that these rubber trays will affect mouth damage, as the radiation can easily penetrate them. I do, however wear the bottom one during my radiation treatments because after having some teeth pulled, the remaining ones do not line up exactly right, and the pressure the mask puts on them is uncomfortable, and probably not good for the teeth. Thus the guard, which works wonderfully well. I certainly hope your dentist knows something I don't!
Joanna

I had to wear my upper tray during radiatio because of a filling that I have. Both the radiation oncologist and the dentist felt that particular filling was of a material that would intensify the radiation in that area and possibly lead to burns. Both also felt that there was no benefit to wear the other tray.

When I first started treatment, I asked my docs about wearing something to protect my teeth (metal) that would block the radiation to them. That was not possible as it would affect the beam that was directed at the tumor. I then asked about a lead apron during radiation treatments for my torso and privates. The radiation people told me that it would serve no purpose, as the doses of radiation I was getting were more than would be stopped by a little lead apron (like you wear in the dentists office), i.e. I was going to get blasted to the MAX. So I had to chuckle when I read your post. An oncologist that I spoke with today just laughed...A rubber tray blocking enough radiation to help you teeth? Not likely.

Just to clarify...wearing the tray isn't to protect my teeth...it's to protect the rest of my mouth. I was told the most damage to the cheeks comes when the radiation reflects off of the tooth enamel. The dentist found that by having the extra layer there with the trays, the amount of reflection was cut down and patients had less blistering on their cheeks.