Okay, I finally received my fluoride trays. My Dentist made the trays, and ordered a prescription fluoride gel and PreviDent 5000 dry mouth toothpaste for me to use. First, I use the toothpaste then apply a thin layer of fluoride gel in the trays and use the trays for at least one minute...

Now, my questions...Do I take the trays out before I go to sleep or leave them in? Do I use the trays every night forever?
Do I use this prescription toothpaste forever too? Can I use regular mouth products in addition to the scripts? Should I do my regular mouth maintenance in addition to these fluoride treatments? Should I brush more often? Do I have to see the Dentist more then every 6 months? What happens if I loose a couple of teeth 25 years down the road? What happens if I get gum disease? Am I being too paranoid?

I never really had problems with my teeth and they're in good shape. My Dentist says everything is good to go (he couldn't answer all of my questions because he hasn't really dealt with people going through radiation Tx)...But, I'll be seeing a Periodontist that is very familiar with OC and radiation patients to do a double check on my oral region. I start radiation the third week of September...

Thank you for any advice or suggestions

Hi Ray,

I began using my trays before I started radiation and was told to keep them in my mouth for 10-15 minutes, but not wear them overnight. I was supposed to use them throughout treatment, but towards the end my entire mouth and gums were so sore and tender that I had to stop using them.

Your mouth will be extremely sore from the radiation, and you will probably be given prescription rinses to use and also told to rinse frequently with salt water/baking soda mixture. My doctors recommended Biotene products (toothpaste, mouthwash, etc) as they are non-irritating. I finished radiation over 2 years ago and my mouth is still very sensitive and I'm unable to use many toothpaste brands. Flossing is important, but I wasn�t able to reach my back teeth so I switched to Reach flosser or floss picks.

My teeth were in good shape to begin with and my dentist said I didn't need to use the fluoride trays after treatment was over. Instead of going to the dentist every 6 months, he recommended every 3 months. However, I recently switched dentists and had my first dental x-ray since radiation, and they determine that my jaw bone has deteriorated and I�m at high risk for developing osteoradionecrosis (ORN). After a consultation with my oral surgeon they recommended I see the dentist every 2 months for cleaning and check-up, and they also recommended hyperbaric oxygen therapy (my last dive is tomorrow). They also recommended I start using the fluoride trays again, every night forever! We are at a higher risk of loosing teeth and developing other dental problems, so I feel these added preventative steps are worth it.

By the way, I�m also from the Lehigh Valley and see both Dr. Koch and Dr. Risch. My reaction to radiation has been extreme and I continue to have healing issues. Dr. Risch said I�ve had the worst reaction to radiation of the mouth that he has seen. Hopefully your experience will be much better than mine.

I hope I answered at least some of your questions. Good luck!

Hi fellow Lehigh Valley residents

If having any major dental work after radiation you may need to do the hyperbaric treatments even years down the road. Yes you will need to see a dentist more frequently. Hopefully David will respond as he is very good with dental info. We also have Jerry and Dr Mike who are dentists here who can help you. You arent being paranoid, its called being proactive in your treatment.

Dr Koch suggested to me to get a water pik. That was one of the best things Ive done to help keep my mouth clean. He also gave me a prescription for Peridex rinse which I dilute in water and use in the water pik three times per day. This worked for me cuz I am unable to open my mouth wide enough to brush properly.

Another toothpaste that is good is the Biotene brand. Ive never used prescription toothpaste, but know regular kinds can burn your mouth.

Ray,

I started using my trays 1 month before my Tx started and I used them all thru Tx except for a few nauseating nights and I have used them every nite since Tx ended. My dentist says I should use them forever. Now my instructions were to keep them in for a minimum of 3 mins and not to drink anything for 30 mins so I just keep them in for the whole 30 mins. I know some have complained about a burning sensation but I have never encountered that. I stopped using the Prevident and switched to the generic (Name escapes me) because the generic is much much cheaper and my ins didn't cover the fluoride Tx. I use biotene drymouth toothpaste and will forever.

Ray

Flouride trays are forever. A minute sounds too short: I was told 3 minutes minimum and do before bed so it would stay on through the night. Don't worry if sometimes during the radiation it does not work out to use the trays due to nausea or whatever, just start up again when you can. I know we all sound like we have stock in Biotene, but their toothpaste, mouthwash and dry mouth spray really work.
Be sure to write out your questions you posted and bring it with you to ask your prosthodonist (amazing how easy it is to forget until you've left the chair). My dentist was and is great but had zero experience with OC so I have switched to the prosthodontist for now to deal with some post radiation complications. I know it all sounds daunting but keep the faith. You can do this
tom

I do as David does and just leave them in for the full 30 minutes -- Mine were a little uncomfortable at first, but a little custom trimming with my Swiss army knife made them comfortable (now I'm using the Swiss army knife scissors to trim back some of the free flap so I can chew without chewing my new tongue and hopefully can get back to using the trays again soon).

Pete! You just made me wince a little bit

Do it yourself surgery?

Swiss army knife scissors!!..... oh the irony of it all. A real Swiss army knife does not even have a cork screw anymore.... and neither is it red.

Pete I hope you are joking!

M

Mine were perfect from the git go but all that changed when I forgot and left them on my bathroom sink overnight and one of my cats got them and took them all over the house. I found them the next am after a 1 hour search and tear down and now they feel a little "off balance" in my mouth but I'll survive.

Actually, I'm not joking -- There's some bleeding (there's some bleeding in that area all the time just from touching it trying to brush or from biting it -- Much less now that I've trimmed some) -- There's no pain involved because the nerve connections haven't grown to the new tongue -- I rinse the area out thoroughly with peroxide and then the oral rinse I got post-surgery -- Essentially, it's like trimming a hangnail...