Commonly Asked Radation Questions
What are some of the side effects of radiation therapy?
In addition to its desired effect on cancer cells, radiation therapy often cause some unwanted effects, especially in your mouth. People who receive radiation therapy to the head and neck may experience redness, irritation/sores in their mouth, a dry mouth or thickened saliva (spit), difficulty swallowing, and changes in taste.
Along with these side effects comes a decreased ability to keep your teeth clean, which can lead to radiation caries (tooth decay) and tooth loss.
How long will these side effects last?
While the redness/ soreness will go away soon after your radiation is complete, the changes in taste and dry mouth are permanent. There are some ways to reduce the discomfort caused by these side effects.
What are radiation caries and why do they occur?
Radiation caries is defined as tooth decay (cavities) that results from dry mouth following radiation therapy. Saliva (spit) protects teeth in 2 ways. First it helps to rinse food off of your teeth and secondly it helps to neutralize the acids that cause tooth decay.
How do I prevent ‘radiation caries’?
The best way to prevent tooth decay is to keep your mouth meticulously clean.
It is helpful to develop a routine; Dr. Penchas and the other Houston dentists at MidtownDentistry recommend four easy steps.
- Brush your teeth with a super-soft toothbrush.
- Floss teeth by sliding the floss up and down each side of each tooth, making sure that the floss hugs the tooth.
- Apply your prescribed fluoride using your fluoride carrier (described below) to help strengthen your teeth.
- Baking soda rinses (1 tsp. baking soda to one quart of water) to neutralize acids that cause tooth decay.
What are Fluoride Carriers?
Fluoride carriers are custom molded plastic trays made by Dr. Penchas at MidtownDentistry in Houston to be filled with prescription fluoride gel to help prevent decay and strengthening your teeth.
How Do I use my Custom Fluoride Carriers (Trays)?
- At bedtime, remove your dentures from the mouth.
- Brush and floss your teeth as you would normally with soft toothbrush and regular toothpaste. Note: It is very important to remove all food and plaque from between teeth before using fluoride. Food and plaque can prevent the fluoride from reaching the surface of the tooth.
- Place a thin ribbon of the fluoride into each fluoride tray so that each tooth space has some fluoride, filled about 1/3 of the way.
- Place the trays on the upper and lower teeth and let them remain in place for 5 minutes. Only a small amount of fluoride should come out of the base of the trays when they are placed.
- After 5 minutes, remove the trays and thoroughly spit out the excess.
Important: Do not rinse mouth, drink or eat for at least 30 minutes after fluoride use.
When is the best time to use my fluoride carriers?
The best time to use your fluoride carriers is right before bed. It should be the last thing you do before you go to sleep.
How do I take care of my fluoride carriers?
Rinse your trays thoroughly after each use and allow them to air-dry overnight, outside of their container.
Do not boil the trays or leave them in a hot car because they may warp or melt.
Why should I be concerned about tooth loss?
After head and neck radiation, your ability to heal after a tooth is removed is decreased. If a tooth is removed in an area that has had radiation, it is a significant chance (30%) that a non-healing bone infection will develop called ‘osteoradionecrosis’. If this infection develops, further surgery may be needed to remove infection.
I’m a denture wearer, what are some of the things that I should be concerned about?
It is really important that your dentures are comfortable. If your dentures cause sore areas in your mouth, it is important that you take out your dentures until you can see your dentist. Your dentist has special techniques to find the area on your denture that is causing the problem and make you dentures more comfortable to wear.
What are some suggestions to keep my mouth from getting so dry?
There are several products, available at your local pharmacy, that help keep your mouth from getting dry and uncomfortable. Every product is a little different and no one product that works for everyone. Our Houston dentists recommend trying several different products until you find one that works best for you.
Other tips include:
- Sipping plain water throughout the day is a good way to keep your mouth from getting really dry. Sugary drinks (juices, sodas, sports drinks) are highly discouraged because the sugar can lead to tooth decay and tooth loss.
- Trying special food preparation – blended and moist foods are easier to swallow.
- Avoiding the use of alcohol-based mouth rinses, these will tend to dry out your mouth more.
- Avoiding the use of tobacco and alcoholic beverages.