Mouth and teeth problems after radiotherapy

Cancer treatment can affect oral tissues and oral complications from radiation to the head and neck can compromise patients’ health and quality of life. This is the reason why patients diagnosed with cancer should take care of their mouth and teeth before, during and after cancer treatment. In this article we will focus on radiation side effects on patients’ oral health.
Patients with cancer who are recommended radiotherapy will experience some oral complications. These complications have various forms and degrees, depending on the individual and the cancer treatment. Some problems go away after treatment but others last a long time.

Does head and neck radiation affect the mouth?

Both head and neck radiation are used to kill cancer cells. But this process can also harm normal cells, including cells in the mouth. Side effects include problems with your teeth and gums, glands that make saliva and jaw bones. The side effects can hurt and make it hard to eat, talk and swallow. During radiotherapy you are more likely to get an infection, which can be very dangerous.

What are the oral problems caused by neck and head radiation?

Patients with radiotherapy may experience:

Dry mouth (xerostomia). Xerostomia is dryness of the mouth due to reduced or absent salivary flow. It increases the risk of infection and compromises speaking, chewing and swallowing. Persistent dry mouth increases the risk for tooth decay.
Mouth sores (little cuts in your mouth). This is called oral mucositis. The soreness usually lasts only while you are having the radiation treatment.
Radiation caries. Tooth decay may begin within 3 months of completing radiation treatment if changes in either the quality or quantity of saliva persist.
Loss of taste.
Changes in tastes perception of food, ranging from unpleasant (such as metallic taste when you eat meat) or tasteless.
Infections of your tongue, gums or teeth.
Tissue fibrosis. This means loss of elasticity of masticatory muscles that restricts normal ability to open the mouth.

Should I visit my dentist if I am recommended radiation treatment?

The answer is certainly “yes”. You should visit your dentist at least 2 weeks before starting your radiation therapy. Your dentist will examine your teeth and mouth and do any needed dental work to make sure your mouth is as healthy as possible. If you cannot go to the dentist before the treatment stars, schedule a visit soon after the treatment begins.
Also check your mouth every day to notice if you observe mouth sores or infection.

Some tips if you experience a severely dry mouth:

Sip water often during the day to keep your mouth moist;
Chew sugar-free gum in order to make your salivary glands produce more saliva;
Ask your doctor to prescribe medicines that stimulate saliva;
Use a saliva substitute to help moisten your mouth.

Do not forget to avoid:

Foods that are hot, spicy, or high in acid, which can irritate your mouth.
Sugary foods, like candies or soda, that cause tooth decay.
All tobacco products, such as cigarettes, cigars, pipes and chewing tobacco.
Alcoholic drinks.

What to do in order to have a good oral health during radiation therapy:

Brush your teeth twice a day, two minutes every time. Brush your gums and tongue after each meal and before bedtime.
Use a soft toothbrush.
Gentle floss your teeth every day.
If you have dentures, make sure they fit well. You might find it more comfortable to take them out for some periods during the day. Keep your dentures clean by brushing them each day.

As a conclusion, radiation therapy has a lot of side effects on your overall and oral health. This is why your dentist should talk to your radiotherapy doctor before giving you any dental treatment. If you are a cancer patient who had radiotherapy, call us to make an appointment. 610.647.7611 is our phone number. Dr. Arhiri is here to answer your questions and to do you an examination.

References:

http://www.cancerresearchuk.org/about-cancer/cancers-in-general/treatment/radiotherapy/side-effects/head/head-and-neck-radiotherapy-side-effects-mouth-and-teeth
https://www.nidcr.nih.gov/oralhealth/Topics/CancerTreatment/OralComplicationsCancerOral.htm
https://www.nidcr.nih.gov/oralhealth/Topics/CancerTreatment/HeadNeckRadiation.htm
https://www.cancer.gov/publications/patient-education/radiationttherapy.pdf