Teeth !

Hi MarkEL. As ever Dani’s answers are spot on. Bacteria in our mouths produces acid from the food we eat (particularly sugar and carbohydrates)  and this acid can damage our teeth - post-radio we have less protection from our lower saliva flow. However our saliva does “buffer” the acid after 20-30 mins. Brushing too soon could mean we scrub the acid into our teeth - waiting 30 mins means this is less likely.

Regarding RT affecting our teeth in other ways - I think probably yes it does, but this is not certain or easy to get good info on, but the damage from a reduced saliva flow is MUCH more significant and potentially devastating.

As Dani says, the other problem is that RT reduces the blood supply to the bone of the jaws and puts us at increased risk of Osteoradionecrosis especially if we need a tooth out after RT treatment. But this risk is still low.

Your dentist can still see you if you are classed as vulnerable - it’s your choice. They certainly should not be refusing to see you. They can and should carry out all dental treatment required other than dental extraction or surgery, as these 2 have a small increased risk of initiating  osteoradionecrosis. Extractions should be referred to the Oral Surgery or Maxillofacial Dept at your local hospital and they will want to know the radiotherapy fields - ie how much RT different areas of your jaw received.

Hilary

SLJ65. It sounds like you have an amazing dentist - they do exist. I would ask him about best kind of toothbrush, it depends and he knows you well. I changed to electric when I started treatment, but it’s pretty aggressive and I used it 3-4 times a day - resulting in some significant toothwear which I can see after only 3 years. Yikes! So I concentrate on inter-dental cleaning after meals now, other than twice a day (3 times if I sneak in sugar). Sorry I’ve answered nothing there - but ask the professionals, your dentist and hospital one when you have your appointment. Most importantly - drop the chai latte except for an occasional treat! It’s great that you are thinking carefully about your teeth, and your efforts will pay dividends as time goes by....

Hilary

Sacha

I use an oral B electric rechargeable 2 speed with a sensitive head. Works well 

If you ever need an extraction it MUST be done in hospital but I’m sure your dentist will know that 

Floss or interdental sticks? Or doesn’t it much matter?

Interdental BRUSHES and Floss. they do different jobs

If your interdental space is wide enough brushes do a better job. Where you can't get a brush in then use floss

Thank you again - and yes Hellebore I am so grateful to my lovely dentist.  So sweet of him not to worry me but also to gently make sure that I was getting the treatment I needed.  My ultrasound (of the neck lump) was really delayed and I actually had to go private otherwise I still think I'd be waiting for it now - it was only after this that I got fast tracked (although there were still delays for the MRI but thats another story and was expedited after I reported it to PALS).  I am so very lucky that I could afford to go private.  But yes its wonderful that my dentist got his receptionist to keep calling me to make sure I wasn't ignoring the lump.

I also saw my dentists hygienist before my treatment for a thorough clean and as it turned out she used to work in the maxillo facial department so she made sure I was kitted out with interdental brushes and soft toothbrushes for while I was having my treatment.  Again they didn't charge me.  Actually I had forgotten just how kind they all were in the rollercoaster of diagnosis and treatment.  Just typing this now brings tears to my eyes now.  I must write them a card.

I saw so many specialists and my head (and heart) were reeling after my diagnosis I'm not sure I took everything in that I was told so I think its a good idea to go back to the dentist, stock up and make sure I'm doing everything right (and thank them again).  I will ask about that fluoride coating you are getting Dani.

Sorry everyone - I'm still getting used to this chat and who/how it replies to people when I write here.

Hi again Hellebore do you think it would help to eat (non sugar) chewing gum in between meals if you ate something sugary and couldn't brush your teeth ? Also I wonder if chewing gum might help generally as I do remember I stimulating saliva flow - although I haven't been able to bare the taste of it again just yet.

Sacha. Forgot to mention. I am a slave to chewing gum though these days I can go without it. It does make my saliva flow remarkably so I do take some out with me in my pocket as I don't bother carrying water around with me any more. It's also excellent to chew after meals before I get my teeth brushed. It clears away all the bits that would usually be washed away if my saliva was normal. I use Peppersmith which has xylitol as the sweetener. Steer clear of fruit flavoured sugar free gum as it has citric acid in it

I use ‘Extra’ and it really helps get the saliva going. I’m not sure what the sweetener is.