Oral Health After Radiotherapy: Prevention and Treatment

The cells that provide lining to our mouth are very sensitive to irradiation. Hence, radiotherapy can easily cause mouth sores. Although, the sores might not “live long” if timely identified. It pertains during the radiotherapy and a few weeks after the completion of the treatment.

Pay increased attention to your oral health after radiotherapy. Here is some advice to offer you guidance, however always discuss your options with your doctor

Side effects of radiotherapy in oral cavity:

It is imperative that when radiotherapy is applied, the oral cavity care should be assessed initially and during the whole treatment. Radiation therapy applied to the head and neck can cause side effects in the oral area such as:

  • Dryness
  • Sores
  • Dental decay
  • Infections (in the gum or tongue)
  • Change or loss of taste
  • Stiff jaws and bone deformation
  • Viscous saliva

These side effects occur because radiation, besides killing cancer cells, also harms healthy cells such as those in the inner lining of your mouth and the salivary glands.

How long these problems persist varies from person to person. Mouth sores are likely to disappear after the conclusion of treatment. However, other problems, such as changes in taste, can last for years. And then there are problems that may never go away, like dryness in the mouth.

Prevention and Treatment:

The goal of the treatment should be improving the compliance and reducing morbidity. The effects of irradiation might be acute or chronic in nature. It may increase the chances of getting cavities, so it is worth to keep regular visits to your dental physician for proper check-ups. Following are some key bullets that may help you to identify best treatment and prevention:

  • Pay a visit to a dentist at least two weeks before you have your head and neck radiation therapy. It will ensure that you have good oral health when you enter radiation therapy, thereby reducing problems.
  • Be on the lookout for problems in your mouth so that you know about them as soon as they arise.
  • Maintain your oral hygiene meticulously. Do toothbrush before going to sleep, after meals and floss them every day. Because your gums might be sore, use a soft toothbrush (you can make it softer by pouring warm water over it right before brushing). Use fluoridated toothpaste, and avoid alcohol-containing commercial mouthwashes. Clean your dentures every day by brushing or soaking.
  • Do your best to keep your mouth moist. Good ways of doing this are by taking a sip of water regularly throughout the day, sucking on sugar-free candy or chips of ice and chewing on sugar-free gum. Another option is to use a substitute to saliva that will keep your mouth wet. Ask your doctor regarding any medications that can increase the amount of saliva and thus help keep your mouth moist.
  • When your mouth is sore, choose your food carefully. Eat soft foods that are easy to chew and swallow, such as mashed potatoes, scrambled eggs, and cooked cereals. Moisten food with yoghurt, gravy, sauce, etc. before eating it. Take a small mouthful at a time, chew it slowly and thoroughly, and swallow it with a sip of liquid. The food you eat should be around room temperature.
  • Avoid foods that are crunchy (such as potato chips), hot, spicy, or acidic (like citrus fruits).
  • Refrain from using any alcohol and tobacco.
  • Avoid high-sugar foods (candy, soda, etc.) as these can cause tooth decay.
  • Try to exercise your jaw muscles regularly, about 3 times a day, by opening and closing your jaw 20 times, or as many times as you can before it hurts. Do this regardless of whether your jaw is stiff or not.
  • Inform your doctor or nurse when your mouth is painful. They can help you reduce the pain by using drugs and other methods.
  • Even after radiation therapy is over, good oral care will still be a necessity throughout your life. Schedule regular check-ups with your dentist, and ask him/her about what you can do to ensure good oral health.

Conclusion:

Radiotherapy for the cancers of head and neck increases the chances of oral problems from cavities to mouth  sores. Hence, it is important to maintain good oral health before starting the therapy and throughout to reduce the risk of side effects. However, if you get sores and other dental problems then take soft diet and avoid foods that are sugary and may cause further damage.

References:

  1. Radiation- Appetite and oral problems
  2. Effects of radiotherapy on oral health
  3. Mouth and teeth after head and neck radiotherapy
  4. Oral side effects to radiation