Radiation therapy administered to the head and neck area often results in permanent changes to the saliva. These changes decrease the quantity and quality of saliva, thereby decreasing the natural protective mechanisms against tooth decay. Xerostomia or “dry mouth” can cause your teeth to first become sensitive and then to decay, unless they are properly protected.
Radiation therapy also has a permanent damaging effect on the portion of the jawbone that receives radiation. This effect permanently reduces the bone’s ability to heal and resist infection. Therefore, physicians often recommend that you try to avoid elective dental or oral surgery including gum surgery, placement of dental implants, or extraction of teeth situated in bone previously treated with radiation.
Recommended Daily Oral Care
Clean Your Mouth After Each Meal
- Brush your teeth thoroughly with a non-irritating toothbrush and toothpaste of your choice.
- Floss your teeth carefully and avoid irritating your gums.
- If you have a dental prosthesis, remove it and clean it with a mild liquid soap and water.
Use Prescription Fluoride
- Use prescription fluoride as a toothpaste, a rinse, or a gel.
- Fluoride carriers maximize the delivery of the gel to the teeth and require custom fabrication by a dentist.
- Apply fluoride in the prescribed manner, whether by using a second toothbrush, or (in special cases) by applying a thin coating of the fluoride gel to the inner surfaces of your customized fluoride carriers. The gel loaded carrier should be placed on the teeth and worn for 10 minutes. It is suggested to do this prior to bedtime.
- If your physician has instructed you to use fluoride carriers—following the 10 minute period of application—you should remove the carrier and rinse with cool water to wash away the residue fluoride gel. Store them inside the case in a cool place until the next morning.
- After removal of the fluoride carriers or after brushing on your fluoride, do not rinse, eat or drink for 30 minutes. This helps to prolong the duration of the contact of the gel with the teeth and gums.
Additional Supplies
You can obtain additional fluoride during your return visits with your doctor. Many at-home fluoride gels are available from your local pharmacy. You can purchase them with a prescription from your dentist or physician. One common brand is called Previ-Dent™ Gel (1.1% Sodium Fluoride).
Overall Dental Care After Radiation Therapy
- Keep your mouth clean.
- Use fluoride daily.
- Rinse your mouth frequently during radiation treatment to reduce soreness of the oral tissues and to prevent infection.
- Rinse with a dilute solution of 1 tablespoon baking soda in one quart of water.
- The inflammatory condition that often affects the mouth and throat following radiation therapy is termed mucositis.
- Visit your dentist on a regular schedule, at least every 6 months.
- Have your teeth professionally cleaned by a dentist or dental hygienist at least once every 6 months.
- There are no contraindications to dental x-rays, anesthesia or having your teeth restored.
- Do not have teeth extracted or implants placed and do not undergo gum surgery within the areas of your mouth that were directly treated with radiation, as this could cause severe complications with healing.
Physical Therapy
If your physician instructs you to practice jaw exercises or they have prescribe a device such as a Thera-bite for you to use, it is important that you comply with all of your instructions in order to maintain your jaw mobility, flexibility, and function. These exercises may help treat restricted jaw range of motion, known as trismus, which is a side effect of radiation therapy.
Conclusion
Taking diligent care of your oral health after radiation therapy is essential. Adhere to a recommended daily oral care routine, using prescribed fluoride treatments, and avoiding certain dental procedures in irradiated areas. By doing so, you can effectively manage the risks of xerostomia, tooth decay, and jawbone complications. Regular dental checkups and professional cleanings remain crucial. They will help you maintain your oral health and overall well-being during and after your cancer journey.
