Thursday, July 6, 2017

The Best Home Remedies for Dental Pain

Got a toothache, jaw pain, or an agonizing canker sore? To ease the ouch, look no further than your kitchen cabinet.

Toothaches may be small in size — but they can cause a colossal amount of pain.
. If you have a severe or persistent toothache or other mouth malady, you should visit your dentist in case it’s a serious dental health issue that needs treatment.
However, some minor toothaches and pains can be treated right at home (or at least mitigated while you wait to see your dentist). Next time your mouth is troubling you, give these home remedies a shot.

Toothache Cures From Your Kitchen Cabinet

Grab some clove oil. Oil of clove is an age-old home remedy. It works thanks to the chemical eugenol contained in the oil, which has anesthetic and antibacterial properties. To use it for tooth pain, soak a cotton ball with a mixture made of two to three drops of clove oil and ¼ teaspoon of olive oil. Put the cotton ball in your mouth near the tooth that hurts and bite down to keep it in place. One caution: Don’t go to sleep with the cotton ball still in your mouth. The FDA no longer considers this treatment effective enough to recommend it, although some dentists still believe it has benefits.Clove oil is available at pharmacies and health food stores.
Flush it out. Sometimes, the root of your toothache is food that’s trapped between your teeth. In this case, try flossing, rinsing with mouthwash, or using interdental brushes (small brushes shaped like Christmas trees that work between the teeth). In fact, this home remedy can save you a trip to the dentist’s office — but if food is constantly getting stuck in your teeth, talk to your dentist, because there could be an issue with your gums that needs medical attention.
Try these other kitchen staples. Some other home remedies that have proven to help toothaches include applying a hot tea bag directly to the tooth. Tea contains tannic acid, which reduces swelling. Other solutions: A cucumber slice placed on the tooth or a cotton ball soaked in brandy - alcohol has numbing properties, too. Some people also report that garlic, onions, spinach, wheat grass, or a simple salt water rinse relieves tooth pain.
Home Remedies for Your Other Mouth Maladies
Canker sore? Use these OTC concoctions. Canker sores usually go away on their own — but the pain can be excruciating in the meantime. While you’re waiting for one to heal, you may find relief by applying a mixture of half hydrogen peroxide and half water to the sore with a cotton swab, then follow with a dot of Milk of Magnesia; you can repeat this up to four times a day. Another home remedy to try is a mixture of equal parts Milk of Magnesia and liquid Benadryl; gently swish the mixture around your mouth for 60 seconds and then spit it out.
Sensitive teeth? Try this toothpaste. If your tooth feels sensitive to pressure, or when it’s exposed to hot or cold temperatures, whitening toothpaste is a no-no (it can just make your teeth more sensitive). Instead, try this simple solution: Switch to a no-frills toothpaste or consider buying toothpaste made especially for sensitive teeth, Dr. Dodes says. “They have chemicals in them that desensitize the tooth,” he explains. If sensitivity persists, talk to your dentist, who can investigate the cause.
Got jaw pain? Eat this. Until you can get an appointment with your dentist to check out your jaw pain — or while you wait to see if the pain resolves on its own — switch to a diet of softer foods. “Don’t eat big, overstuffed sandwiches or hard bagels,” Dodes says. “Give yourself five or six days of eating a soft-food diet and see if it gets better. If you twisted your ankle, you wouldn’t run hurdles, would you? If it hurts, give it a break.” Just be sure to call your dentist if the jaw or tooth pain doesn’t go away.
Got swelling? Take these steps. Mouth pain is sometimes caused by swelling of soft tissues in the mouth. Swelling should be checked by a dentist because it could be a serious dental health issue, Dodes says. In the meantime, try taking an over-the-counter anti-inflammatory medication such as ibuprofen (Advil or Motrin). “Still, if you’re in enough pain that you need a pill,” Dodes says, “you better get to a doctor because dental pain tends to get worse and worse.”
Broken tooth? Do this ASAP. If you break a tooth, get to your dentist as soon as possible — this pearly-white problem needs immediate assistance. If you find the piece of tooth that broke off, you can preserve it at home by putting it in water or milk — don’t leave it on a counter, for instance, and never scrub it with cleanser, Dodes says. Sometimes dentists can bond the tooth back on. “By putting it in milk, you’re helping to keep the cells alive so that they will re-grow when it’s reattached.”

Wednesday, June 7, 2017

Overcoming Dental Fear & Anxiety

Overcoming Dental Fear & Anxiety

Comfortable Dentistry in the 21st Century

Overcoming dental fear and anxiety.
Do you feel relatively calm before your dental appointment or are you a little nervous about a visit to the dental office? Do you worry about it days or weeks before the appointment? Are you someone who is actually terrified about dental treatment and worries about it all the time? Do even those things that are supposed to make visits more comfortable just seem to increase the apprehension or feeling of anxiety and being out of control — like anti-anxiety medication, nitrous oxide (laughing gas) or local anesthesia — numbing the treatment area (injections, needles, shots)? Whichever end of this spectrum you might be on, it may be helpful to know that you are not alone.
Actually, having a little or even a lot of nervousness about dental visits is common. Some studies have concluded that up to 75% of people surveyed have at least a little fear about dental visits. In addition it appears that 10%-15% of people have a great deal of fear — so much so, that it prevents them from having any dental treatment at all. There are people who have frequent dreams about dental treatment; some will only eat soft foods because they are afraid that they might chip a tooth and then need dental treatment. As a consequence these individuals who put off having dental treatment suffer for years with toothaches, infections and poor appearance.
It's possible, even for those people who are the most fearful, to reduce their fear and to learn to have dental treatment in a way that feels calm and safe.
While dental fear can result in stress and avoidance of care, it can also have more wide-reaching consequences. For some it affects their whole identity and sense of self worth. They may see other people who don't seem to have the same reactions to dental treatment and begin to feel that something is wrong with them. “Why can't I do this thing that other people seem to do so easily?” In fact, untreated oral conditions may result in even worse general health complications.
In the end, it's in everyone's interest to find ways to overcome dental fear and make dental treatment a calm and safe experience.

Good News

Now for the good news! First, it's helpful for many people who are fearful to know that they are not alone. It's also important to realize that help is available. Actually, experience has shown that even people who have extreme fear about dental procedures can get over their fears and learn to have dental treatment in a manner that feels calm and safe. If you have been afraid for a long time you may have difficulty believing this, but even people with long standing fear can be helped. Before we describe how it's possible to get over dental fear, let's first review some things about what makes people fearful.
Nervous woman.

How do people become afraid of dental visits?

No one is born being afraid of dental visits. So everyone who is afraid has learned somewhere that dental treatment is something to fear. Some people learn this because they've had previous bad dental experiences. The sense of loss of control in the dental environment may be enough to avoid dental treatment forever. And still others may be afraid due to stories they have heard, movies they saw or other indirect experiences. The message conveyed to a child from a scared parent might be that going to see a dentist is something to be afraid of. Such messages may cause individuals to avoid treatment and not have any opportunity to learn that things can be different.
Fear and anxiety can also be reinforced inadvertently. Think about it this way; try to remember a time when you were really afraid of something, do you remember how your body felt? Was your heart beating quickly, palms sweaty, stomach in a knot? Those and other symptoms of being afraid are all unpleasant feelings. So, if someone who is already afraid forces themselves to go have dental treatment and re-experiences those same bad feelings during the appointment, then what they will remember afterward is those same unpleasant feelings. It doesn't matter how friendly the dentist is or how pain free and pleasant the treatment is. What you remember is the feeling of being afraid, thus reinforcing the idea that there is something to be afraid of.
In fact, dental fear begins at the subconscious level. People have what we call an “automatic fear response.” Jane says “I feel like something just takes over and I begin to sweat and my stomach tightens up. I don't really have any control over it.” Since this automatic fear response is subconscious, you can't make it go away using logic or reason. Telling Jane that “there is nothing to be afraid of” won't help. In fact it might make things worse because it could sound like you are saying there is something wrong with her. So, how do we change this pattern of fear and reinforcement? Let's find out.

Getting to Calm and Safe

As we said earlier, it's possible, even for those people who are the most fearful, to reduce their fear and to learn to have dental treatment in a way that feels calm and safe. The basic idea is really very simple. In order to counteract past bad experiences you need to have new positive experiences which lead to the development of improved feelings and attitudes. The more bad experiences you have had or the longer they have gone on, the more good experiences you need before you will have different reactions to the same situation. Dental health professionals know that your mouth is a very personal place and trust is a big part of allowing us to partner in your care.

Imagine a relationship with your dentist where you feel you have the time you need to go at your own pace, the listening relationship that you need to feel safe, and the sense of control you need to reduce any automatic anxiety responses. It might take some faith in the beginning to realize that this is possible, but you really do have the opportunity to have a “Lifetime of Dental Health.”

Patient Profile

Dental patient consulting with dentist.
Jane is 33 years old. She hasn't had any dental treatment in 10 years. She is worried that she has dental problems and should have them taken care of. She has even made some dental appointments in the past decade. She cancelled or just didn't show up to most of them. Twice she did go and have an examination, but didn't go back to have any treatment performed. She changes the channel on the TV if a show has any dental treatment in it and she won't go to movies that show anything about dentistry. Her smile embarrasses her and has led to poor self-esteem. Jane feels bad about herself. She wants to change both the way she feels and reacts to dental treatment but she doesn't know how.

If you are very fearful, how do you have a “good experience” with dental care?

  1. Tell your dentist you are afraid, even when setting up an appointment and make sure the dentist is prepared to listen. If you can't talk about it you can't get over it.
    I am very careful to listen to what Jane says and try to understand her “story.” I ask Jane to tell me about her fear of dental treatment. “I'm glad you asked” she says. “I always felt that dentists didn't really want to know.”
  2. The dentist must listen carefully to you in an accepting and non-judgmental way.
    I avoid telling Jane that things will be different, that there is nothing to worry about, or that there is anything wrong with her being afraid. I also avoid any explanations about dental disease or dental procedures until I'm sure that Jane knows that I understand her fear and am committed to working with her to help her overcome it. I know that the best way for me to convey that I care is to listen, not to provide explanations. Jane should feel confident that she is not being judged.
    Of course, some people are better at this than others. If you are afraid, find a dentist who listens to you and who cares about working with you to get over your fear. Some dentists have made themselves quite expert in this area. If you start your work with a psychologist, make a transition from working with the psychologist to working with a dentist who understands and can follow the principles involved in reducing dental fear.
  3. When working to reduce fear, only do things that you can do with mild or no anxiety.
    I reassure Jane that she is in control of the situation at all times. I need Jane to tell me exactly what she is afraid of since it's different for everyone. It's critical that I understand what brings on her particular fear reactions. We will start by having Jane try to do those things that she feels she can do fairly easily. The idea is for her to have the goal of being able to leave each visit saying “that was OK; I could certainly do that again if I needed to.”
  4. Set up an agreement so you can take whatever time you need to get over your fear and not be rushed to do things you are not ready to do.
    Let's stop to emphasize the last point, since this can be a significant shift in expectations. In order to help someone get over their fear of dental procedures, the goal for each visit is for you to have a good experience rather than getting a particular procedure finished. Remember, if you push yourself to do something you are really afraid of, you will remember how unpleasant your fear is and reinforce the fear rather than diminish it.
  5. If you are afraid, work with your dentist and make a specific plan to reduce your fear. Don't just concentrate on “fixing your teeth!”
    It's critical that both the dentist and patient agree that becoming comfortable with dental procedures is something that they are going to work on. Understand that you and your dentist must consider your internal anxiety feelings by working at a pace where you will be more comfortable and trusting. Set up an agreement with your dentist to talk about the time and fees associated with treatment so you can comfortably overcome your fear and not be rushed to do things you are not ready to do. This may result in a procedure taking a little longer than usual to complete or spreading out appointments over the course of time.

Saturday, May 13, 2017

Foods that Mask Bad Breath

Foods That Mask Bad Breath

These common foods can help hide halitosis
 at least for a  short while.

The issue with foods like onions and garlic is that they contain pungent oils that get carried through your bloodstream to your lungs. When you breathe out, the pungent leftovers are exhaled too.
Fortunately, just as eating certain foods can cause your breath to be unpleasant, other foods can help mask bad breath — for a time. “It will only be temporary,” notes Gerald P. Curatola, DDS, clinical associate professor at the New York University College of Dentistry and an oral health and wellness expert for The Dr. Oz Show. The following foods could provide relief for an hour or two, until you are able to attack the underlying cause — odor-producing bacteria in your mouth.

Bad-Breath Busters

Foods that can help mask bad breath include:
  • Parsley. Parsley is probably one of the most well-known ways to treat bad breath. Its oils are what do the trick. Likewise, spearmint and cinnamon can help mask bad breath. Some other herbs and spices that work for the same reason are coriander or cilantro, tarragon, eucalyptus, rosemary, and cardamom. ·
  • Green tea. Green tea contains catechin, a powerful antioxidant that can fend off bacteria — remember, bacteria causes the unwanted odor. ·
  • Yogurt. Some studies have shown that the live active cultures in yogurt help reduce bad breath, Dr. Curatola says. If the yogurt has probiotics (good bacteria), it can overpower the bad, foul-smelling bacteria. ·
  • Apples and pears. “Fruits help with the production of saliva, which is essential to nourishing and rebalancing the natural oral ecology of the mouth,” Curatola says. ·
  • Oranges, melons, and berries. These fruits in particular are rich in vitamin C. Vitamin C not only is helpful for keeping bacteria in check, but also helps combat gum diseases and gingivitis, which also can cause bad breath. ·
  • Celery, carrots, and cucumbers. These crunchy munchies encourage the production of saliva, the bacteria rinse agent. ·
  • Almonds and other nuts. They work like fruits and vegetables. “The fiber-rich content of fruits, vegetables, and nuts also acts like ‘tiny toothbrushes’ on teeth and has been shown to keep odor-causing bacteria from staining teeth,” Curatola says.

More Ways to Mask Bad Breath

Other ways to treat halitosis:
  • Drink water. You want to keep your mouth moist. Water rinses out your mouth, and it's generally good for your system.
  • Chew sugarless gum. It not only masks the odor but also promotes the production of saliva, which helps rinse your mouth of harmful plaque and bacteria, explains Kimberly Harms, DDS, a dentist in Farmington, Minn., and a spokeswoman for the American Dental Association.
  • ·
  • Pop some breath mints. Like eating sprigs of parsley or other herbs, sucking on breath mints will mask the odor for at least a little while, Dr. Harms says.
Be sure the gum and mints you choose are sugarless. Sugar creates plaque, and you could be adding to the problem if you chew on sugary sweets or gum.

Practice Good Dental Hygiene

Food is really only a temporary solution to any bad breath problem. Most important, practice good oral hygiene. Brush your teeth for at least two minutes twice a day and floss daily. If bad breath is a problem, be sure to brush your tongue as well — that's where odor-causing bacteria like to live, especially at night when your mouth is dry. Make certain to get regular dental checkups.
If bad breath is a persistent problem, talk with your doctor. It could be a sign of something other than the onions you had at lunch.

Friday, April 7, 2017

Economic Aspects Of Single Implant vs. 3-unit Fixed Bridgework(Evaluating Your Options)

Dental Implants

Evaluating Your Options for Replacing Missing Teeth

Economic aspects: Comparing the Cost of Implants to Fixed Bridgework

Consider this scenario: if you lose a single tooth, the two most common methods of tooth replacement are a tooth supported bridge or an implant supported crown. The American Dental Association (ADA) reports that bridges last an average of 10 years. Clinical studies indicate that implants are over 95% successful for 20+ years. Therefore, a conservative cost breakdown over 20-25 years may look like the chart below.
Dental implant options.
Even with partial insurance reimbursement, the cost of a tooth supported bridge is more expensive long term. The total cost over 20-25 years or more could be significantly higher than shown above. And with an implant supported crown, the adjacent teeth are not compromised so that additional treatment is not necessary. Consider too, the concept of amortization — the process of decreasing or accounting for the cost over the period of time they are likely to last.
Implants may seem more expensive initially. But for patients who are candidates, not only are they a better treatment choice, they will last longer, possibly a lifetime, thereby making them the ideal choice and most cost effective option long term. As we shall see in part two when we guide you through the marketing hype, well planned implants most often require a team approach in assessing whether they're right for you. Placing implants and attaching crowns to them require precision procedures and techniques.
Dental implants vs bridgework
  • Esthetic, functional, predictable, reliable
  • Does not affect adjacent teeth
  • Does not decay
  • Less likely to develop gum disease
Disadvantages of Dental Implants
  • More expensive
  • More planning time
  • Requires minor surgery
  • Requires healing time before permanent tooth replacement
Advantages of Bridges
  • Esthetic, functional, predictable, reliable
  • Less costly
  • Requires less time for final result
Disadvantages of Bridges
  • Requires enamel removal of adjacent teeth
  • If adjacent teeth have crowns, they must be redone
  • Tooth decay is potential problem
  • Root canal treatment may be required if nerves are affected
  • Greater tendency for gum disease
  • Less longevity than implants

Friday, March 3, 2017



Our teeth are irreplaceable and we cannot do without them. Did you know that eating the right foods can do as much good for you as regular brushing and flossing? Did you realize that some food and drink will not only help keep your teeth in shape, but also feed them, too? Snack on some fruits and vegetables while counts down the top 10 foods to benefit your dental health.
Top 10 Foods for Your Teeth:
1.    Green Tea has a well-deserved reputation for providing many benefits. With teeth, green tea offers up natural antioxidant compounds prevent plaque from accumulating, therefore reducing the risk of cavities and bad breath. Some green teas also contain fluoride that can further prevent tooth decay – check the label before you buy.
2.    Dairy products such as milk and yogurt are low in acidity and sugar making them great choices to quench your thirst or have as a healthy snack. This is good news for both tooth erosion and tooth decay. Milk is rich in calcium, which means you are fortifying teeth and bones while refueling during the day.
3.    Cheese is another dairy product with significant dental benefits. Being high in phosphate and calcium, cheese promotes healthy teeth. It also balances the pH in your mouth, produces more saliva, rebuilds tooth enamel and kills the bacteria that cause tooth cavities and gum disease.
4.    Fruit is great for your teeth especially when eaten in whole, raw form. It keeps down plaque and massages your gums. Choose the fruits rich in Vitamin C, which holds our body cells together. If you are short of Vitamin C, your gums may become tender and more susceptible to gum disease.
5.    Vegetables are another good idea if you are trying to build a good foundation for your teeth. Broccoli, carrots, sweet potato and pumpkin are rich in Vitamin A from which tooth enamel forms. If you eat them raw you will get more Vitamin A, as well as clean your teeth and massage your gums.
6.    Onions are rich in powerful anti-bacterial sulphur compounds, which kill the bacteria that harm your teeth and gums. If you can stand the stinky side effects, eat onions raw for best results.
7.    Celery is another great friend of the dentist. Eat it raw and it will not only massage your gums, but clean your teeth. It will also induce the production of more saliva that will neutralize the bacteria that cause cavities.
8.    Sesame Seeds, which are best combined with bread and rolls, dissolve plaque and help build tooth enamel. The tasty seeds are also rich in calcium, which will keep your teeth and jawbone healthy.
9.    Proteins like beef, chicken, eggs and turkey are rich in phosphorus. Calcium combines with phosphorus and Vitamin D to produce our teeth and bones. Make sure you get enough protein to keep your teeth healthy, and reduce decay.
10.    Water is not only the gift of life. When you rinse with water, it cleans your mouth so that your saliva can nourish your teeth, hydrate your gums, and help wash away trapped food particles that can create plague.
We hope you’ll be able to eat your way to dental wellness by making better food choices that will build up a strong foundation.

Sunday, February 5, 2017

Oral Bacteria Linked to Preterm Labor

Oral Bacteria Linked to Preterm Labor

 16 Jan 2017   
Oral Bacteria Linked to Preterm Labor
Researchers at the University of Hawai’i (UH) at Mānoa will examine tissue samples from women who experienced preterm labor for the presence and type of oral bacteria. According to the researchers, oral bacteria that cause dental caries can be transmitted through the bloodstream from the mouth to other parts of the body, including the placenta, and contribute to the development of serious systemic diseases.
“The first step of our project will be working in the lab, analyzing samples of placentas to determine the presence of any oral bacteria, and, if so, what type is identified because there are many different types of oral bacteria,” said principal investigator Maureen Shannon, a UH Mānoa professor and Frances A. Matsuda Endowed Chair in Women’s Health.
“Based on what we find, the second step will be working with our research team to design and conduct an intervention study to decrease the transmission of maternal oral bacteria to other parts of the body as well as reduce transmission of the bacteria to the women’s infants,” Shannon said. 
About 40% of pregnant women experience caries, which are associated with preterm labor, preterm birth, and low birth weight. The overall goal of the research is to reduce dental disease in mothers so they won’t experience pregnancy complications like preterm labor and birth or pass the cavity-producing bacteria on to their infants and children.
“We are committed to conducting research that can have a beneficial clinical impact for Hawai’i mothers and their keiki [children],” said Shannon.
Native Hawaiian, Pacific Islander, and Filipino women have the highest rates of dental disease in Hawai’i, according to the university. By identifying the presence and type of oral bacteria found in placental tissue, the researchers hope to increase understanding about the way oral bacteria can contribute to the development of preterm labor. Determining the type of bacteria also can help in developing clinical interventions to reduce the rates of pregnancy complications and other diseases associated with caries.

Monday, January 2, 2017

Mouth Care For Cancer Patients

  • dana farber logo

Mouth care for cancer patients:

Patients who are receiving cancer therapy often have changes in the mouth. This information can help you understand possible side effects of cancer treatment, including tips for mouth care that may help prevent or minimize these changes.

Introduction to mouth care:

Chemotherapy affects rapidly dividing cells. Cancer cells and some normal cells, such as those lining the mouth, the gastrointestinal tract, bone marrow cells, and hair cells, divide rapidly.
Chemotherapy cannot tell the difference between normal cells and malignant cells and sometimes injures both. Chemotherapy may lower your white blood cell count, platelet count, and red blood cell count. This is known as bone marrow suppression (another name is myelosuppression). This makes you more at risk for infection and/or bleeding.
If there is pre-existing dental infection such as cavities, abscesses, or gum (periodontal) disease, the infection may become worse. In addition, your gums may bleed easily if they are irritated or swollen.
Chemotherapy may also cause mouth sores (mucositis). These sores usually heal in one to two weeks; however, more serious ulcers may become infected with bacteria or yeast that are commonly found in the mouth. Irritation from sharp teeth or fillings may worsen the condition. Medications to prevent sores and help with discomfort are available and can be prescribed for you.
As a comfort, ask for ice chips or sugar free popsicles to suck on while you are receiving chemotherapy. Research has shown this may decrease mouth sores by 60 percent.

If you receive radiation therapy to your head or neck:

Radiation therapy is often used to treat individuals with cancer of the head and neck. It is delivered to the head and neck area to destroy cancer cells but unfortunately, some normal cells are injured as well. During radiation treatment, patients may also experience mouth sores. This usually lessens within a couple of weeks after therapy ends. Unlike chemotherapy, radiation therapy has long-term side effects in the mouth. The most common side effect is dry mouth (xerostomia). Xerostomia is a result of radiation injury to the salivary glands. It means the salivary glands produce less saliva and the saliva is thicker. The normal protective effect of saliva on the teeth is lost and there is an increase in oral bacteria that cause cavities. Also, plaque and tarter deposits occur faster, which places you more at risk for cavities and gum disease.
Another side effect of radiation treatment to the head and neck is severe bone infection. This is caused by a decrease in the blood supply to the bones of the head and tissue of the neck during radiation treatment. These changes result in slow healing from infection, trauma or especially when teeth are removed soon after radiation therapy. Restorative and preventive dental care is very important to avoid infection.
To prevent infection and tooth decay, it is very important to see your dentist early in your treatment and to continue good mouth cleaning daily. Outlined below are helpful suggestions for mouth care inpatients undergoing cancer treatment.

Before treatment with chemotherapy or head and neck radiation

See your dentist so that (s)he may identify potential sources of dental infection or irritation. Teeth with severe infection or those that may cause problems during or after therapy should be removed (extracted). Extractions should be done at least one week before the start of chemotherapy or radiation therapy to provide enough time for proper healing. Teeth with cavities should be restored with fillings. A thorough cleaning and scaling of teeth should be done to remove tartar (calculus). All sharp areas should be smoothed to prevent unnecessary irritation. Procedures that may be included in the first dental visit are:
  • Dental examination and x-rays
  • Dental cleaning
  • Impressions for fluoride trays. Fluoride trays are custom-fitted soft plastic trays that are used to apply fluoride. Fluoride is used to help prevent the formation of cavities.
  • Oral hygiene instructions:
    • brush three times a day with a soft toothbrush
    • floss daily
    • apply fluoride gel to teeth with custom tray twice daily
    • eat a nutritionally balanced diet, low in sugar

During treatment with chemotherapy or head and neck radiation

During treatment it is important to adhere strictly to your mouth care plan. If your mouth is sore, some of the following tips may help:
  • Use a soft toothbrush or a sponge applicator such as a toothette to brush your teeth.
  • Don't floss if it causes bleeding when your platelet count is low.
  • Wear dentures only for meals.
  • Rinse your mouth with warm salt water or baking soda and water (a teaspoon of either dissolved in eight ounces of warm water).
  • Avoid commercial mouthwashes because they contain alcohol that may burn your mouth.
  • If your doctor prescribes both an antibacterial rinse (Peridex) and an antifungal rinse or lozenge (nystatin), do not take them together because they will not work as well. Separate them by at least one hour.
  • To prevent discomfort when eating, you may apply Viscous Xylocaine to your mouth, especially before meals. Viscous Xylocaine can be swished and spit out or it can be applied directly to a specific area with a cotton tipped applicator. Other topical anesthetics are available at your pharmacy. Ask your doctor or nurse about specific products.
  • Pain medicine may also be used. Tylenol or stronger pain medication may help reduce oral pain. If taken half an hour before meals it may be more comfortable to eat. It is important to avoid using aspirin or non-steroidal medication (Advil, Motrin) products while on chemotherapy since they may cause bleeding problems.
  • Do not smoke cigarettes, cigars, pipes, or chew tobacco and avoid drinking alcohol. These are all very irritating and drying to a sore mouth.
  • Avoid spicy food and food that is difficult to chew. Citrus and tomato juice may irritate your mouth when you have mouth sores.
  • Dry mouth (xerostomia) can be helped by drinking plenty of fluids throughout the day.
  • Drink at least eight glasses of water or juices daily.
  • Avoid caffeinated beverages as the caffeine may increase mouth dryness.
  • Artificial saliva can be tried and is available in most pharmacies. You may find that chewing sugarless gum or sucking on sugarless candy is helpful. Coating your lips with a lip balm such as Vaseline or Chapstick will help prevent them from cracking. A cool mist humidifier will add moisture to your room.
Fluoride treatments are important during and after radiation treatments to the head and neck area. They should be done twice daily by using soft trays that are custom made for you by your dentist.

Fluoride treatment is performed as follows:

  • Brush your teeth with a fluoride toothpaste
  • Place approximately four drops of fluoride gel into the tooth depressions in the plastic tray and spread it with a cotton swab. Gel-Kam is a common fluoride gel. If Gel-Kam irritates your teeth or gums you may find that Prevident is less irritating.
  • Place trays in your mouth and keep them in for a full five minutes. Try not to swallow any fluoride. Remove trays and do not rinse your mouth or take any food or drink for one hour.
  • Rinse the tray. Repeat this routine twice a day.

It is important to call your doctor:

  • If your mouth pain increases and you are unable to control it with your pain medicine.
  • If you are unable to eat or drink because of severe mouth sores.
  • If you have a fever.
  • If you have bleeding that is difficult to control.
  • If you have any difficulty swallowing.

After treatment with chemotherapy or head and neck radiation

When therapy ends, you need to continue with good dental care in order to keep your teeth and gums healthy. Your salivary glands will be making less saliva and you will still be at risk for developing cavities and gum disease.
You will need to have:
  • Dental visits with scaling and cleaning at least three times a year.
  • Continued fluoride treatments with fluoride trays twice a day.
  • A nutritionally balanced diet, low in sugar.
  • If any dental extraction becomes necessary it is important that your dentist talk with your oncology team who are familiar with your treatment.
Mouth dryness may continue after therapy. Salivary flow will gradually increase, but may not completely return to normal. To add moisture to your mouth it is helpful to:
  • Carry a water bottle to wet your mouth as needed.
  • Drink at least eight glasses of water or juices per day.
  • Keep caffeine at a minimum.
  • Avoid alcohol and tobacco products.
  • Moisten foods with gravies or sauces.
  • Chew sugar free gum or suck on sugar free sour drops.
  • Try artificial saliva.
  • Ask your physician, dentist or nurse to recommend commercial products that are available for dry mouth.
  • Use a cool mist vaporizer.
Dentures should be made or relined about six months after treatment to allow for changes in your mouth. There should be no pressure areas which could result in irritation to your mouth.
  • Taste changes during the first six months following radiation therapy are common. You may find a decrease in taste and an altered taste sensation. These changes may result in a decrease in appetite. It may help to:
  • Try different foods, if they are not agreeable, you can try again at another time.
  • Add various herbs and mild spices.
  • Avoid adding extra salt if you have high blood pressure.
  • Add liquid food supplements to increase caloric intake until your appetite returns. Ask your nurse or see one of our dietitians for more suggestions.
  • Weigh yourself frequently until weight stabilizes.