Hi all,
Yes there is another thread on fluoride. I decided to copy my post to this thread so that others can read it without trying to find it.
Hi all,
Gary makes a great point when talking about dry mouth and the use of fluoride. He has posted in great detail about his dental journey in the past and what he has experienced, and he has experienced it all, unfortunatly for him. As usual he is accurate and timely in his advice. I offer the following information to provide assistance to any who may require it.
When chemo/radiation impair the function of salivary glands the bodies natural protective mechanism for our teeth becomes impaired. The best way to protect your teeth when this hapens is with the regular use of topical fluoride. Fluoride application will also reduce tooth sensitivity caused by gum recession and dry mouth as well as strengthen the interface between fillings and enamel. Some fluoride releasing dental filling materials will as well be recharged with fluoride upon topical application these are commonly known as Glass Ionomers.
There are many choices when choosing a topical fluoride. Rinses, gels and foams. All are proven to have no significant differences when used properly. As Gary states, you should choose a pH neutral fluoride. It won't give you the burn feeling and as well, it will not affect adversly any porcelain or composite (bonding) that is present in your mouth.
Custom fabricated trays are a great idea. They fit well, hold the fluoride against the teeth and will cause you to use less fluoride. Fluoride can be toxic if ingested in some individuals if enough is consumed (mind you it takes a lot). It can also cause stomach and GI problems. Make sure you are using the appropriate concentration. It is recommended, and most manufacturers of topical fluoride products follow these guidlines, that for daily use a concentration of 0.05 neutral sodium fluoride be used. There are many different brands Oral B, Butler, NuFoam to name a few and most pharmacies in North America carry them or can order them for you. If not, your dentist can order it for you.
Weekly application should be a concentration of 0.25 neutral sodium fluoride. Your dentist should be your partner in this endeavor so that you have someone to guide you and answer any questions or address any problems that may occur.
Gary, the foam is a great product. Foam fluoride bottels should be stored at room temperature with the top of the cannister on the counter top or upside down. This will ensure that you will not waste the fluoride and that the "gas" that propels it out of the cannister is always pushing the fluoride out.
Fluoride foams basically have the same appearance of hair mousse. When utilizing foam products less is more. Fluoride is diffusive and will spread through your mouth or tray with the help of saliva even if you don't have a lot. A note of caution that should be mentioned when foams are being considered is that some manufactures use egg white protein to produce the foam. Anyone who is allergic to eggs should read the label carefully or choose a gel or rinse.
Discuss the protocols with your dentist and be sure to maintain your regular cleanings and exams and you may also want to increase the frequency of these visits even if there is an out of pocket expense.
Cheers,
Mike

Hope this helps.
Mike

I am presently using the flouride trays. I've lost 4 teeth (now have implants) and I have so far had 3 teeth crowned and need 4 more. I, too, switch back and forth every 3 months between the dentist and periodontist but the decay came up all of sudden and all at once. Everyone was looking at my bones, then all of a sudden they noticed the decaying. I read Bob Wilson's Adjunctive Therapy but need to find out what PO bid is to try his solution for drymouth.

KristyN,
"PO BID" is short form written on prescriptions it basically means; Orally Twice a day. It can also be written as "PO Q12h" which means taken orally every twelve hours.
I hope this helps.
Cheers,
Mike

I'm 18 mos. from radiation (entire oral cavity - 66gy) - very dry, trismus - on evoxac, trental, nystatin (rinse w/biotene)- need to drink water all the time especialy if I eat anything - need to wash down food also to stop pain. I think drymouth is also the culprit with mouth tissue irritation - teeth with no saliva rough up tissue and then causes pain.

Please tell me how logically PO BID = Orally twice a day?

Definition of p.o.

p.o.: Abbreviation meaning by mouth, orally (from the Latin "per os", by mouth). One of a number of hallowed abbreviations of Latin terms that have traditionally been used in prescriptions.

Some others:

a.c. = before meals (from "ante cibum", before meals)
b.i.d. = twice a day (from "bis in die", twice a day)
gtt. = drops (from "guttae", drops)
p.c. = after meals (from "post cibum", after meals)
p.r.n. = when necessary (from "pro re nata", for an occasion that has arisen, as circumstances require, as needed)
q.d. = once a day (from "quaque die", once a day)
q.i.d. = four times a day (from "quater in die", 4 times a day)
q._h.: If a medicine is to be taken every so-many hours (from "quaque", every and the "h" indicating the number of hours)

hope this explains

love liz

Thanks, Liz. Still weird though. How about BM 2xD.

David LOL!!!!

Mike,
I noticed you are a dentist in Canada. I've read that primarily coming out of Canada, the dentists there use vis-a-lite or blue light technique to detect early stage oral cancer. My dentist, ENT or RO do not use - do you? what are your thoughts particularly for someone who has gone through oral radiation treatments for scc?
Thanks

Jim04,
Dentists are trained in Canada and the U.S. to perform a standard oral cancer screening. This includes but is not limited too; extra and intra oral visual inspection preferrably with magnification, extra and intra oral palpation and proper documentation and a clinical description of any areas that vary from normal. A follow-up examination is recommended for abnormal tissues within 2-4 weeks. At the follow-up examination if abnormal areas or tissues are still present then further investigation is recommended whether it be another re-examination, biopsy and/or referral. The Vis-A-Lite and Blue Light techniques are techniques that can be used by practioners to aid in their examination. I use the Velscope. These additional procedures and techniques, no matter which one, are adjuncts to the normal inspection that should be done. They all have their pros and cons but, provide information to the clinician that is not available to the naked eye.
Jim the Velscope was developed in Canada and has recieved much hype as have other diagnostic tools for the early detection of oral abnormalities but, the standard of care as far as I am aware in Canada and the U.S. is a proper medical history, visual and manual inspection. These additional aids are helpful but are unfortunatly underutilized, in my opinion. Dentists who do not incoorporate these additional procedures in their practice are not underservicing their patients as long as they are being diligent in their visual and manual inspections.
Brian has on several occasions posted about dental examinations and there is an extensive description for patients and dentists about examinations on this site. Unfortunatly many dentists do not perform regular comprehensive Oral Cancer screenings and examinations in their practices.
I hope this answers your question.
God Bless.
Mike