Expert Information on Oral Cancer & Dental Oncology

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Oral Cancer is the Most Common Cancer in North America

Oral cancer is a growing concern.  It is, sadly, the most common cancers affecting people in North America, The 5-year survival rate is less than 50 percent

If you do have cancer, your cancer treatment causes dental complications; some of these can become chronic or painful.

Dry mouth is one of the complications from cancer, but other patients may experience overly sensitive teeth.  Teeth that decay quickly could also be an issue.

Oral Cancer Needs to Be Treated Quickly

Treat all Oral cancer quickly.  If it isn’t, cancer that spreads to new facial tissues is not uncommon.  It could also spread to the neck.  Both of these are painful — and could cause disfigurement.  If you are older than 40, you should be especially aware.  Studies show that oral cancer is found most often in older adults (men, especially).  However, it is not uncommon for oral cancer to appear in younger people. It usually appears on a person’s tongue, but other places in the mouth like the lips are also a possibility.

Dr. Jonathan Penchas at Midtown Dentistry is an expert in dental oncology and can help detect cancer early on.


If you see lumps or patchy areas in your mouth, it may be an early sign of oral cancer.  Other symptoms could be lesions or sores in your mouth.  Often these early warning signs of oral cancer are not painful, so they are often missed.

What are the Signs of Oral Cancer?

  • Hoarseness
  • Difficulty swallowing
  • Unusual bleeding in your mouth
  • Sores in your mouth that won’t heal.
  • Lumps in your throat or neck
  • Unusual growths in your throat or neck.

The US National Institute of Health Oral Cancer Page


Young women diagnosed with oral cancer have more than doubled during the last 3-decades. And researchers aren’t sure why. The human papillomavirus, tobacco, and alcohol use do not seem to be the cause according to the studies. Approximately 25 percent of people who get oral cancer is a non-smoker and may only drink moderately.
Scheduling regular checkups at our office can help limit your chances of developing this cancer.


If you have had or are having cancer radiation therapy to your head or neck, you may experience:

  • Sores in your mouth
  • Thick saliva
  •  Dry mouth
  •  Some difficulty when swallowing food, liquids or saliva
  • Changes in the taste of food

Because of the pain and discomfort that comes with the side effects of radiation therapy, you may not be able to brush or keep your teeth as sparkling clean as you usually would.  This may lead to tooth decay or even tooth loss.

How to reduce oral challenges during cancer radiotherapy

Look for An Expert in Dental Oncology

Proper oral and dental care is critical if you have oral cancer both during your cancer treatments and after. This is because oral cancer radiation treatment will make your mouth more prone to bacteria and decay. The dental expertise needed to handle the oral health issues of cancer patients is different from what a general dentist can do.  It’s dental expertise that should be handled by a certified dental oncology expert.

What is Radiation Caries and Radiation Decay?

Radiotherapy is often an essential part of managing oral cancer, but unfortunately, it can cause unwanted side effects. The radiotherapy treatment can mean the exposure of the salivary glands, jaws, and buccal mucosa. The side effects can include xerostomia or dry mouth, losing the sense of taste, or it can lead to the oral tissues becoming inflamed and painful.

Besides, patients who have undergone radiation treatment are more at risk of developing radiation caries. This condition occurs as a result of someone receiving radiotherapy to the head and neck area. It can develop several weeks after the completion of radiation therapy and can affect the teeth in several different ways.

radiation caries

It’s not uncommon to see lesions develop in the teeth at the junction where the teeth meet the gums, called the cervical area. This type of radiation caries can lead to the loss of the crown portion of the tooth. Another common side effect is to see the teeth becoming eroded and worn on the chewing and biting surfaces. This occurs due to the hard outer enamel layer of the tooth becoming softer, meaning the teeth are much more susceptible to developing cavities, or radiation caries. Another problem that is sometimes seen is that the crown area becomes discolored, and may appear brown or black.

Some patients may exhibit one form of radiation caries, while others may develop one or more different types of this condition. It can affect teeth that weren’t directly irradiated. At the moment, the exact effects radiation therapy can have on teeth aren’t yet known, as studies have given conflicting results. Some studies have found demineralization to be a factor in irradiated teeth, while others have found no significant difference between non-irradiated tooth enamel and irradiated tooth enamel. More studies have looked at the effects of radiation on the pulp area or central part of the tooth, but again they have proved inconclusive. One factor that does seem to be important is the way radiation therapy affects saliva.

Saliva and Radiation Caries

The therapy has quite an effect on the salivary glands, causing the saliva to become thicker. This can lead to difficulties in eating and speaking and increases the risk of radiation caries. Saliva has a significant role to play in oral health as it helps keep the mouth clean and reduces the chances of disease by helping to wash away bacteria. Besides, saliva is vital in assisting the teeth in remineralizing.

Remineralization is a necessary process that helps keep the enamel layer of the tooth strong and healthy. Every time you eat something sweet or full of carbohydrates, then your teeth come under acid attack. The acid has the effect of leaching out essential minerals from the enamel, resulting in it becoming softer.  Around half an hour to an hour after eating, the mouth becomes less acidic, and essential minerals in the saliva are redeposited into the tooth enamel during remineralization. Patients who have undergone radiation therapy can see the composition of the saliva change, as the treatment can affect its antibacterial qualities, and can reduce its capacity for remineralization. With this capacity decreased, the likelihood of caries developing due to radiation increases.

Reducing the Risk of Radiation Caries

In an ideal world, the salivary glands would be spared during radiation therapy, but obviously, this is not always possible. However, preventative dental care can help if it is provided before, during, and after treatment, although it’s not still possible to prevent radiation caries from developing. It can help to make sure plaque levels are adequately controlled, to use fluoride in a form prescribed by your dentist, and use artificial saliva substitutes, or to try to stimulate the flow of saliva.

Choosing your diet can also help reduce the risk, although this can sometimes be quite difficult to do. Patients who have undergone radiation therapy may find it a lot more comfortable to eat soft, sticky foods that are easy to chew and swallow, but unfortunately, these aren’t always the best thing for teeth. Choosing a dentist who is experienced in treating cancer patients can help a lot as they understand the clinical and biological implications of cancer therapies, and more able to provide optimal dental treatments.

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Our Patients Love Midtown Dentistry

” They are all very welcoming, professional and knowledgeable, especially hygienist Loan Pham. I recently got braces and my  teeth look and feel great every time I leave her chair, even now with braces – she’s amazing.”

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