When radiation treatment is directed to the head and neck regions, several important dental considerations arise. The problems that result are due to the effect of the radiation on the targeted tissues, namely the jaw bone and salivary glands. As a result, the jaw bone cannot respond as well to infections, and the salivary glands cannot function to produce as much protective saliva for the gums and teeth.
Potential problems include:
- Mucositis – irritation of the cheeks, lips, and tissues within the mouth
- Xerostomia – dry mouth resulting from decreased salivary function
- Loss of taste – due to dry mouth
- Constricture of muscles
- Secondary infections – bacterial and fungal infections due to changes in salivary flow
- Sensitive teeth
- Tooth decay – a higher risk for decay exists due to decreased salivary flow
Prevention of problems include:
- Removing hopeless teeth which may cause jaw bone infections if not treated
- Restoring all large cavities
- Establishing good oral hygiene
- Daily fluoride rinses – 10 minutes/day in custom trays
- Chlorhexidine rinses – 3 times/day for 30 seconds to control plaque and fungal infections
- Rinsing 4 times/day with sodium bicarbonate (baking soda) diluted in water to control acidity – mix ½ teaspoon of baking soda and salt in a glass of water
- Controlling xerostomia with frequent sipping, ice chips, or synthetic saliva
- Frequent dental visits – every 3 months to monitor health and complications
These precautions are recommended to prevent loss of teeth, provide comfort to the tissues, and avoid osteoradionecrosis, an infection that involves the jaw bone. Contact the dental office if concerns and questions arise.
