Why Dental Care Before and After Radiation Therapy Matters So Much

When people hear they are about to start radiation therapy to the head and neck, their teeth are usually the last thing on their mind. Yet talk to those who have been through it, and a common refrain is, "I should have gone to the dentist first." Radiation does not strike only the cancer cells; the salivary glands, gums and jawbone that lie in its path are affected too. That is why taking the time to get your mouth in order before treatment begins can make a bigger difference than you might expect.

The most common change people notice is a drop in saliva. Less saliva means not only the discomfort of a dry mouth, but also a weakening of the bacteria-clearing and acid-neutralizing jobs saliva normally does. As a result, tooth decay can spread far faster than usual. Some describe brushing exactly as before, yet feeling their teeth crumble and turn brittle. What makes this truly worrying is that once a jawbone exposed to radiation is damaged, it heals very slowly.

For that reason, what a dentist focuses on at a pre-treatment check-up is whether there are any teeth that need attention beforehand. If a tooth is already badly damaged or borderline as to whether it can be saved, it is often safer to deal with it before treatment starts than to pull it out after radiation. Extracting a tooth from bone that has received radiation carries the risk that the wound will not heal well and the bone becomes exposed, leading to osteonecrosis. So do not put the dentist off; ideally, see one as soon as your treatment schedule is set.

Once treatment begins, caring for your mouth becomes an almost daily task. Many people brush gently with a soft toothbrush and a mild toothpaste, and keep up with the fluoride products their care team recommends. Alcohol-based mouthwashes only sting an already dry mouth more, so they are best avoided, and the habit of frequently holding water in the mouth to keep it moist turns out to help a great deal. When your mouth becomes sore and raw and eating gets hard, do not just grit your teeth through it alone; telling your care team right away means relief comes faster.

Care does not end when treatment does. Salivary gland function may gradually return over time, but it is also common for it never to be quite the same again. So it is important to see a dentist regularly to catch cavities early, and whenever an extraction is needed, to always mention that you have had radiation therapy. When your care team and dentist share information with each other, risky procedures can be avoided.

In short, dental care is not a sideline to radiation therapy but one of its pillars in getting through treatment safely. A comfortable mouth means you eat well, and eating well means you can endure treatment. This article is general information only, so be sure to discuss what is right for your own situation with your care team.