- Acid Reflux
- Being on Oxygen
- CPR and Anesthesia concerns
- Dry Mouth - Xerostomia
- Dental Issues
- Nebulizer Usage
- Neck and Shoulder Dysfunction
- Pain Management
- Peg Tube
- Recurrent Disease
- Second Primaries
- Stroke and Vascular Problems Related to Head Neck Radiation
For many years, I have used a mixture of 1/2 Peroxide (3%) and 1/2 Listerine Mint mouthwash for rinsing, swishing, and brushing my teeth using the Sonicare. It helps with coffee stains and, in my opinion, helps to control the growth of yeast in the mouth, especially when used just before bedtime so the mouth is clean of food all night.
This year one of our members, Phil B from CA, brought me a bottle of a product I had not seen before. He said it is like what you mix up. It is called Peroxyl, an anticeptic oral cleaner, and is made by Colgate. It promotes healing, helps prevent infection by reducing bacteria, and gives you a clean mouth. The peroxide in it is 1.5% and it has a minty flavor. They do have one with an alcohol-free formula for sensitive mouths.
I think it is a good product. The cost is a good bit higher than what it costs to make the mixture I have been using but it is convenient.
My problems with Oral Health after Radiation
According to my learned SLP, Dr. Carla Gress, there are two main problems with radiation and dental issues. The first problem is a dry mouth caused by the effect of radiation on the salivary glands. A dry mouth allows air to get to the teeth. Air on the teeth can promote bacterial growth. And we all know that bacteria on the teeth can lead to cavities. The second problem is the effect of radiation on the blood vessels to the teeth. Radiation actually scars our blood vessels. The scar tissue causes our blood vessels to shrink. The shrunken blood vessels may restrict some of the blood flow to the teeth. Too much blood restriction can lead to our teeth possibly dying and breaking off. Please keep in mind that these are possible side effect of radiation on your teeth. Some of us experience them and some of us do not.
As a side note, this vessel shrinkage can effect the neck arteries as well. Many of us have had ultrasounds to determine if we have any arterial problems. In my case, for example, my right neck artery is flowing in the 39 to 50 percent range and is considered tortuous, which means the blood is not flowing in a straight line. When I turn my head to the right for more than a second I can pass out. The doctor gave me the sage advice "don't do that." Then he sent me a bill.
The efforts for attacking this real of potential dental radiation problem include frequent brushing of teeth, e.g., after every meal and at bedtime. Also, treating teeth with a fluoride solution. I use Prevident 5000 which I must get from my dentist by prescription. Another treatment you may consider is a mouthwash containing a small solution of peroxide in it.
One thing a new laryngectomee may not understand is that with our new limited ability to swallow we don't realize that food can lay in the mouth unswallowed. I made this mistake. I further made the mistake of not brushing at bedtime when I was really sick and tired from the radiation and chemo treatments. I thought that I would brush in the morning and that would be okay. Well, it wasn't.
I discovered that I could manage to eat ice cream. So, in the evening I would have a cup of vanilla ice cream with chocolate syrup on top. I didn't realize that the residual syrup would just lie in my mouth and stain my teeth. Bad move. Only too late did I discover the error of my ways. Now my dentist, who is a saint, is working very hard to restore my teeth and give me a smile back that I can be proud of.
So, please learn from my mistakes and keep your oral care up to snuff. One lapse such as mine can lead to a lot of dental health problems. Like we used to say in the Navy, eternal vigilance is the price of safety. Or in this case it is the price of oral health.
Lary since 2010
Dental and Radiation
Articles on the WebWhispers site:
Changes in Dentition Following Head and Neck Cancer Treatment
Elizabeth Feldman, MS, DMD, MS
MD Anderson Cancer Center Orlando
VoicePoints, our professional column in Whisper on the Web:
Speaking Out - Dental Problems (from our members)
That's a Hard Pill to Swallow, Part III
Tammy Wigginton, M.S., CCC/SLP
VoicePoints about swallowing, which contains excellent information about dental problems.
Dry Mouth - Xerostomia
Another section under this category of Possible Problems relating to Dental
Implants - Carl Strand - report Written Dec 2012
As usual, we are all different. In 1991 I did 7 weeks of radiation for a total of 7000 rad (I know the units have changed) which I was told was the maximum for me. I had issues with the bottom front five teeth, resulting in root canals, pins and finally bonding one tooth to the adjacent two. I used flouride trays and finally Prevident 5000 toothpaste. This situation
maintained itself with regular visits to my peridontist including cleanings until 2008 when both the periodontist and my regular dentist felt the situation was becoming unstable.
The periodontist consulted with my radiation oncologist who felt I was a candidate for implants, which I elected to pursue. I went through the procedure of extraction, bone grafts, three implants after healing and finally placement of a permanent bridge. I had no issues with healing, placement of the implants and all. I said on Webwhispers that I would report back after three years on the outcome. There have been absolutely no problems except a much lighter wallet - not having any dental insurance.
I have no idea why I have been fortunate to not experience the issues described by some of you with necrosis, healing issues, need for hyperbaric treatment, etc. I have had two more implants in the upper back of my mouth, but currently have twenty six teeth in my mouth.
All that is to say that sometimes we get lucky.
Carl Strand - Radiation summer of 1993 - Laryngectomy February 1993
On Line References
Web sites that can help answer questions are:
The Oral Cancer Foundation has a good explanation of how radiation affects dental issues.
The National Institute of Dental and Craniofacial Research talks about the protential problems with radiation treatments.
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