| Joined: Mar 2002 Posts: 4,916 Likes: 61 OCF Founder Patient Advocate (old timer, 2000 posts) | OCF Founder Patient Advocate (old timer, 2000 posts) Joined: Mar 2002 Posts: 4,916 Likes: 61 | This dentist should have his head examined. 2mm of scaling isn't much - this is not deep root planing. And if you develop significant periodontal disease in an area that is going south now and needs professional cleaning, you are going to have the very problem he thinks you are going to avoid by letting the bacterial plaque and calculus remain. Freakin' unbelievable. I hope Doc Jerry chimes in here cause I am sure he is going to mirror Doc Mikes Comments.
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. | | | | Joined: Jan 2009 Posts: 253 Gold Member (200+ posts) | Gold Member (200+ posts) Joined: Jan 2009 Posts: 253 | Dear Brian and other list members: What would you suggest for dental cleaning prior and after chemo/radiation treatment. I had an oncologist dentist examine my teeth prior to induction therapy. There is a lot of metal restoration, but teeth look okay.
I've finished chem and have 4 weeks until radiation. Time enough for my mouth to heal, and I'm thinking about removing the metal filling, cleaning the the cavity and replace the filling with other material, but for the present only on the side where the cancer is located.
What's everyone's opinion. Also, I'm very confused. What should be my dental tx during and after radiation. I know my mouth will be extremely sore. Everyone seems to be doing something different.
This info will really help me choice the right dentist.
Thanks Sandy
Last edited by SandySt.; 04-06-2009 07:35 AM.
Sandy 56, BOT SCC Biopsy 1/21/09 Stage 3, T3NXM0. Finished 3 cycle induction chemotherapy 4/7/09. (Chisplatin, 5-fu and Texotere). Re-staged 4/20/09,(very successful.) Will start Carboplatin/radiation 2 Gy/5 days/7 weeks (Tomotherapy) starting May 4th. Finished 6/22/09. OCF member/supporter
| | | | Joined: Sep 2006 Posts: 8,311 Senior Patient Advocate Patient Advocate (old timer, 2000 posts) | Senior Patient Advocate Patient Advocate (old timer, 2000 posts) Joined: Sep 2006 Posts: 8,311 | Has anyone mentioned the fluoride trays? I was told to begin 30 days before the rad began and I still use them nightly. The fluoride is to help strengthen the teeth against the damages of radiation.
David
Age 58 at Dx, HPV16+ SCC, Stage IV BOT+2 nodes, non smoker, casual drinker, exercise nut, Cisplatin x 3 & concurrent IMRT x 35,(70 Gy), no surgery, no Peg, Tx at Moffitt over Aug 06. Jun 07, back to riding my bike 100 miles a wk. Now doing 12 Spin classes and 60 outdoor miles per wk. Nov 13 completed Hilly Century ride for Cancer, 104 miles, 1st Place in my age group. Apr 2014 & 15, Spun for 9 straight hrs to raise $$ for YMCA's Livestrong Program. Certified Spin Instructor Jun 2014.
| | | | Joined: Apr 2008 Posts: 117 Likes: 1 Senior Member (100+ posts) | OP Senior Member (100+ posts) Joined: Apr 2008 Posts: 117 Likes: 1 | I've been using fluoride trays. I don't remember when I started. Maybe when treatment started. But this is another area where opinions are different. I was told to put them in for 5 minutes, remove them, but then I should NOT rinse, brush, eat or drink for 30 minutes after that. The fluoride is OMNI Gel 0.4% Stannous Fluoride.
[quote=davidcpa]Has anyone mentioned the fluoride trays? I was told to begin 30 days before the rad began and I still use them nightly. The fluoride is to help strengthen the teeth against the damages of radiation. [/quote]
Squamous cell carcinoma base of tongue. Lymph involvement unclear; staging placed at "2 or 3." Biopsy 4/18/2008. Treatment: IMRT every day for 7 weeks. Cisplaten once a week to sensitize cancer to radiation. Treatment ended 7/16/08. PET/CT shows no more cancer.
| | | | Joined: Sep 2006 Posts: 8,311 Senior Patient Advocate Patient Advocate (old timer, 2000 posts) | Senior Patient Advocate Patient Advocate (old timer, 2000 posts) Joined: Sep 2006 Posts: 8,311 | Andrew,
I was told to put them in before bedtime for a minimum of 3 minutes and not to drink for 30 mins after. I just keep them in for 30 mins and go to bed after I take them out. I have never had a problem keeping it in my mouth for that long. My dentist says I should continue to use the trays forever but he isn't really adamant about that. I also switched to a generic brand that costs 1/3 of what I use to pay.
David
Age 58 at Dx, HPV16+ SCC, Stage IV BOT+2 nodes, non smoker, casual drinker, exercise nut, Cisplatin x 3 & concurrent IMRT x 35,(70 Gy), no surgery, no Peg, Tx at Moffitt over Aug 06. Jun 07, back to riding my bike 100 miles a wk. Now doing 12 Spin classes and 60 outdoor miles per wk. Nov 13 completed Hilly Century ride for Cancer, 104 miles, 1st Place in my age group. Apr 2014 & 15, Spun for 9 straight hrs to raise $$ for YMCA's Livestrong Program. Certified Spin Instructor Jun 2014.
| | | | Joined: Aug 2007 Posts: 580 "Above & Beyond" Member (500+ posts) | "Above & Beyond" Member (500+ posts) Joined: Aug 2007 Posts: 580 | Fluoride is a great idea but for patients undergoing head and neck cancer therapy, chemo and radiation, it is an essential component of maintaing and improving your oral health and prventing your teeth from breaking down. Chlorohexidine 0.12% rinses are also excellent in lowering and controlling periodontal bacteria in individuals with gum disease, ulcers, and compromised immune systems. Fluoride has been discussed at length in many threads and posts on this site many times. Just type "fluoride" in the search bar and you'll have plenty of information to read. As for the scaling below 2 mm being detrimental...I do not agree. The average healthy sulcus is 3mm. Bottom line is bacteria, plaque and calculus are toxic to tissue and need to be removed. They are pathogenic to gums and bone and in order to maintain gum and bone health they need to be removed at any depth.
Cheers, Mike
Dentist since 1995, 12 year Cancer Survivor, Father, Husband, Thankful to so many who supported me on my journey so far, and more than happy to comfort a friend. Live, Laugh, Love & Learn.
| | | | Joined: Sep 2008 Posts: 489 Platinum Member (300+ posts) | Platinum Member (300+ posts) Joined: Sep 2008 Posts: 489 | Can we have a show of hands - how many of you receive antibiotics either pre or post cleaning?
Patty
48 SCC Floor of Mouth 7/06 9/06 Surgery, bilateral neck dissection, 58 nodes clear PT2pN0pMx 35 rad 2006 Recurred 6/08, 1 Carboplatin, 1 Cisplatin Surgery 9/08 - Total glossectomy, free flap from pectoral muscle, left mandible replaced using fibula 35 IMRT & Erbitux 11/08 4/15/09 recurrence 6/1/09 passed away, rest in peace
| | | | Joined: Sep 2006 Posts: 8,311 Senior Patient Advocate Patient Advocate (old timer, 2000 posts) | Senior Patient Advocate Patient Advocate (old timer, 2000 posts) Joined: Sep 2006 Posts: 8,311 | Not here and I went right back to my pre Tx cleaning routine in every way possible. I have had the same dentist for about 18 years and he even came to my house twice during my Tx just to check up on me.
David
Age 58 at Dx, HPV16+ SCC, Stage IV BOT+2 nodes, non smoker, casual drinker, exercise nut, Cisplatin x 3 & concurrent IMRT x 35,(70 Gy), no surgery, no Peg, Tx at Moffitt over Aug 06. Jun 07, back to riding my bike 100 miles a wk. Now doing 12 Spin classes and 60 outdoor miles per wk. Nov 13 completed Hilly Century ride for Cancer, 104 miles, 1st Place in my age group. Apr 2014 & 15, Spun for 9 straight hrs to raise $$ for YMCA's Livestrong Program. Certified Spin Instructor Jun 2014.
| | | | Joined: May 2002 Posts: 2,152 Patient Advocate (old timer, 2000 posts) | Patient Advocate (old timer, 2000 posts) Joined: May 2002 Posts: 2,152 | Patti, I have NEVER been given an antibiotic before or after dental scaling and cleaning.
Andrew, I had a cleaning appt with my prosthodontist who specializes in oral cancer patients and he said he has never heard anything so silly. 2mm is nothing. He said if the patient has a 5mm pocket you scale to 5 mm because not getting the plaque out would create more problems. Basically you scale as deep as necessary to remove the plaque. I have several very deep pockets that I had even prior to radiation (my teeth have very long roots) and have never had a problem with them being scaled. I think I'd find a new dentist if I were you.
Take care, Eileen
---------------------- Aug 1997 unknown primary, Stage III mets to 1 lymph node in neck; rt ND, 36 XRT rad Aug 2001 tiny tumor on larynx, Stage I total laryngectomy; left ND June 5, 2010 dx early stage breast cancer June 9, 2011 SCC 1.5 cm hypo pharynx, 70% P-16 positive, no mets, Stage I
| | | | Joined: Aug 2007 Posts: 580 "Above & Beyond" Member (500+ posts) | "Above & Beyond" Member (500+ posts) Joined: Aug 2007 Posts: 580 | Antibiotics prior to dental treatment this is a great topic and, in my humble opinion, misunderstood by many dentists and patients. Antibiotics are prescribed to patients who are percieved to be at risk of developing bacterial endocarditis as a result of dental treatment. The basic regulations as to who needs them and how much has changed very little over the last 20 or so years. Here is a link to a site that explains the rationale and science of this situation; http://www.aafp.org/afp/980201ap/taubert.htmlA long story short, the simple facts are that when you have your teeth cleaned bacteria that are already present in your mouth are introduced in large quantities into your bloodstream (the same thing happens when you brush your teeth.) Individuals who have prosthetic parts in their bodies especially in or around their hearts are at risk for the potential colonization of bacteria on these prosthetic parts which could lead to a potentially fatal result. The American Heart Association; http://www.americanheart.org/presenter.jhtml?identifier=1200000publishes guidlines for medical and dental practitioners to follow to best prevent this situation in patients who are at risk. Radiation therapy and/or chemotherapy to the head and/or neck do not put a person at a higher or abnormal risk of developing bacterial endocarditis after dental treatment. There is no science or research that I am aware of that supports prescribing antibiotics to patients who are undergoing radiation and/or chemotherapy to the head or neck to reduce the risk of bacterial endocarditis. So relax everyone and don't get anxious if your dentist doesn't prescribe an antibiotic before your filling or hygiene appointment. If you are at all concerned about this ask your dentist. I'm sure they would be more than happy to discuss it with you. Cheers, Mike
Last edited by Dr. Mike; 04-19-2009 08:19 AM.
Dentist since 1995, 12 year Cancer Survivor, Father, Husband, Thankful to so many who supported me on my journey so far, and more than happy to comfort a friend. Live, Laugh, Love & Learn.
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