Oncology Dentist: Is it recommended to see a specialist?

Posted by vickie1320 @vickie1320, Jul 14, 2023

Hi, my husband is 2 weeks in his radiation and chemo for tonsil cancer. He has seen our family dentist and he is not given much advice as to dental care. Thank God for this forum! Do you recommend seeing the dentist associated with the cancer center? I’m very worried about his teeth. We are using 1.1 fluoride in his trays 2 x day and he is brushing/flossing 3-4 times daily. Please any advise is so appreciated.
Thank you so much

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The only advice I was given was to take care of my teeth if I want to keep them. Mostly, the information was about treatment of oral sores. Reduced immunity makes a person susceptible to all sorts of infections. I have excellent teeth, and want to keep them that way. Usually, I use a brush without toothpaste, brush and massage my gums while watching television. I use 3% hydrogen peroxide diluted about half and half with water as a mouth wash. It debrides, whitens, and disinfects all at the same time. But that's me, and it may not be something you want to try. I have been putting off a cleaning, because it probably creates a lot more opportunity for infection. But I did get my semi-annual inspection with x-ray, and everything was fine. Don't forget to brush your tongue!

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@puddknocker

The only advice I was given was to take care of my teeth if I want to keep them. Mostly, the information was about treatment of oral sores. Reduced immunity makes a person susceptible to all sorts of infections. I have excellent teeth, and want to keep them that way. Usually, I use a brush without toothpaste, brush and massage my gums while watching television. I use 3% hydrogen peroxide diluted about half and half with water as a mouth wash. It debrides, whitens, and disinfects all at the same time. But that's me, and it may not be something you want to try. I have been putting off a cleaning, because it probably creates a lot more opportunity for infection. But I did get my semi-annual inspection with x-ray, and everything was fine. Don't forget to brush your tongue!

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Thank you that’s fantastic!

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I forgot to mention that I also floss.

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From what I understand is that generally if you have teeth issues, this should be addressed prior to radiation treatments. If you have no issues then normal dental care should be fine. Your dentist should be able to understand and explain any abnormal issues with the teeth and gums as well as the mouth. Most dentists and many oral hygienists are excellent at discovery of issues. A surprising number of oral cancers are discovered by dentists. You can certainly ask your dentist if he/she understands what to look for with oral cancer and tooth care. Any professional would not be offended and it will open the conversation.

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@hrhwilliam

From what I understand is that generally if you have teeth issues, this should be addressed prior to radiation treatments. If you have no issues then normal dental care should be fine. Your dentist should be able to understand and explain any abnormal issues with the teeth and gums as well as the mouth. Most dentists and many oral hygienists are excellent at discovery of issues. A surprising number of oral cancers are discovered by dentists. You can certainly ask your dentist if he/she understands what to look for with oral cancer and tooth care. Any professional would not be offended and it will open the conversation.

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At my last dental exam, dentist said gums were getting to be an issue. Try a water pic. Did it for six months while learning not to spray the mirror or myself so much. Got a "good gums" during my pre-radiation exam. Start off low pressure and may want to talk to doc before considering it.
P.S. talked to a guy just finishing rad/Chem. He said the salt/baking soda gargle was effective for throat care. Don't see why it wouldn't help with tooth care as well.
I'm planning to use the pic during my treatment and may consider dissolving saltbaking soda in the pic water. I'll see what doc says. Good luck.

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@paulreese

At my last dental exam, dentist said gums were getting to be an issue. Try a water pic. Did it for six months while learning not to spray the mirror or myself so much. Got a "good gums" during my pre-radiation exam. Start off low pressure and may want to talk to doc before considering it.
P.S. talked to a guy just finishing rad/Chem. He said the salt/baking soda gargle was effective for throat care. Don't see why it wouldn't help with tooth care as well.
I'm planning to use the pic during my treatment and may consider dissolving saltbaking soda in the pic water. I'll see what doc says. Good luck.

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Thank you. I’ve been thinking about getting a water pic as I’ve read many people use them.

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@hrhwilliam

From what I understand is that generally if you have teeth issues, this should be addressed prior to radiation treatments. If you have no issues then normal dental care should be fine. Your dentist should be able to understand and explain any abnormal issues with the teeth and gums as well as the mouth. Most dentists and many oral hygienists are excellent at discovery of issues. A surprising number of oral cancers are discovered by dentists. You can certainly ask your dentist if he/she understands what to look for with oral cancer and tooth care. Any professional would not be offended and it will open the conversation.

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My dentist always checks around my neck and underneath my tongue, looking for lumps or swelling. Unfortunately, dentists and other health care providers can only act on their own training and experience, the same as all of us. They may hesitate to refer a patient to a specialist unless they are really sure its outside their own expertise. When I went to see my GP about the lump on my neck, he put me on antibiotics for 10 days instead of immediately referring me to a specialist. I had to call his office twice to remind him that he was supposed to make the call if the lump had not gone away after the antibiotic treatment. By then the lump had grown from the size of a pea to the size of a walnut. A specialist generally won't see a patient unless they have a referral from another doctor. Those referrals can be hard to get. It may be an insurance issue, I don't know.

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@paulreese

At my last dental exam, dentist said gums were getting to be an issue. Try a water pic. Did it for six months while learning not to spray the mirror or myself so much. Got a "good gums" during my pre-radiation exam. Start off low pressure and may want to talk to doc before considering it.
P.S. talked to a guy just finishing rad/Chem. He said the salt/baking soda gargle was effective for throat care. Don't see why it wouldn't help with tooth care as well.
I'm planning to use the pic during my treatment and may consider dissolving saltbaking soda in the pic water. I'll see what doc says. Good luck.

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That might maintain the water pic as well. My wife uses one of those. I have to run peroxide through it sometimes because scum grows in the pump and tubing.

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Hello,
I hear you on the worried about the teeth!
I’m 7 years out of stage IV treatments and still worry about my teeth.
I brush several times a day with prescription fluoride as well as whitening paste and get my 2 cleanings and checkups per year. I also get fluoride treatments during my 2 cleaning, my insurance covers one and I pay for one($45.00).
Wishing you the best

MOJO

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My husband had oral cancer in his cheek. After surgery, radiation and chemotherapy, he can not open his wide enough for a full cleaning by a dentist. After he was finished with treatment, Imsearched for a dentist who had some knowledge about treating a patient after oral cancer.
We finally took him to see an oral surgeon who did panoramic X-ray. He then sat down and explained everything he saw. My husband’s teeth have shifted and the radiation did cause damage to his teeth and gums.

The oral surgeon recommended 4 dentists that he knew that were familiar with oral cancer patients. My husband uses a watepik, has higher fluoride toothpaste and a special mouthwash. His new dentist is wonderful and also explained the issues and treatment plan.

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