how to protect teeth during radiation treatment

• brush three times a day with a soft toothbrush
• floss daily
• apply fluoride gel to teeth with custom tray twice daily
• eat a nutritionally balanced diet, low in sugar

Full Answer

How does radiation treatment affect the teeth?

 · A number of companies are providing toothpaste specifically for those patients that are undergoing radiation or suffering from other salivary disorders with a much higher level of fluoride than standard off the shelf toothpaste contain [ 7 ]. Patients should also use a sodium fluoride gel on their teeth after they have brushed.

What should I do if my teeth hurt after radiation treatment?

Use of prescription-strength fluoride:The fluoride concentration of over-the- counter toothpastes may not be enough to prevent dental decay during or after radiation. Your dentist may recommend using prescription-strength fluoride toothpaste, gels, and/or varnish in addition to over-the-counter products.

Is it safe to extract teeth after radiation treatment for salivary gland?

Maintain oral hygiene Brush teeth and gum with a soft bristle brush 2–3 times a day for 2–3 min Rinse the toothbrush in hot water every 10–30 s to soften the bristle if needed Use antibacterial rinse Use a fluoride toothpaste with a mild taste, flavoring may irritate the …

Does your dental practice offer radiation therapy for cancer?

How can I reduce problems in my mouth? Keep your teeth as clean as possible. . Many more bacteria and germs can cause tooth decay and infections in a mouth... Use fluoride in custom gel trays. . Studies on the use of fluoride in custom made gel trays show a reduction in tooth... Treatment of sore ...

Can you lose your teeth from radiation?

Chemotherapy and radiation therapy may cause changes in the lining of the mouth and the salivary glands, which make saliva. This can upset the healthy balance of bacteria. These changes may lead to mouth sores, infections, and tooth decay.

Can I have dental treatment while having radiotherapy?

Do not provide elective invasive dental treatment to a patient currently receiving chemotherapy or radiotherapy to head or neck, or to those who received chemotherapy or radiotherapy to head or neck in the previous six months, or had a stem cell/bone marrow transplant in the last six months, without taking advice from ...

What is the best toothpaste for cancer patients?

Use a fluoride toothpaste or baking soda with fluoride....Some examples of these are:Biotene® Supersoft Toothbrush.Sensodyne® Extra Soft, Gentle Toothbrush.Colgate® 360 Sensitive Pro-Relief Toothbrush, Compact Head, Extra Soft.Oral-B® Indicator 35 Compact Head Toothbrush, Soft.

Does radiation directly damage tooth structure?

Radiation in the head and neck area can lead to direct damage of hard tooth structures such as changes in crystal composition, increased enamel solubility, and decreased microhardness, but unfortunately the mechanism of radiation-related caries has not been accurately described (14).

Why do you have to pull teeth before radiation?

Extractions prior to head and neck radiation are often recommended to reduce the risk of osteonecrosis of the jaws after radiation.

Why does dental decay occur more rapidly after head and neck radiation?

Treatment of head and neck cancers (HNCs) involves radiotherapy. Patients undergoing radiotherapy for HNCs are prone to dental complications. Radiotherapy to the head and neck region causes xerostomia and salivary gland dysfunction which dramatically increases the risk of dental caries and its sequelae.

What is magic mouthwash for cancer?

Magic mouthwash is the term given to a solution used to treat mouth sores caused by some forms of chemotherapy and radiation therapy. Mouth sores (oral mucositis) can be extremely painful and can result in an inability to eat, speak or swallow.

How do you prevent mouth sores from radiation?

Benzydamine (an anti-inflammatory drug) may help prevent mouth sores in people getting radiation treatment to the mouth or throat. Morphine rinses may help relieve pain from mouth sores in this same group of people. Dexamethasone (a steroid) has been used in mouth rinses to help with cleansing and discomfort.

Can you use baking soda to brush your teeth?

Baking soda is an effective teeth whitener when used appropriately to brush the teeth. Keep in mind that it is also important to maintain regular dental visits and continue using a good toothpaste with any baking soda brushing routine.

What is near the oral cavity that is especially sensitive to radiation?

The movable mucosa of the cheeks, lips, soft palate, and ventral surface of the tongue are most often affected, although any soft tissue within the radiation field may be affected.

How long after radiation does the mucus stop?

Changes in your saliva may get better within about 8 weeks of radiotherapy ending. But sometimes it continues for several months or longer. If the mucus continues, tell your cancer specialist or nurse. They may be able to prescribe medicines to reduce the amount you make.

When should you receive an oral evaluation before radiation?

Elimination of oral disease and implementation of oral protocols designed to maintain maximum oral health must be components of patients’ assessment and care before RT begins patients should receive a comprehensive oral evaluation several weeks before radiation begins. This time provides an appropriate interval for tissue healing in the event that invasive oral procedures, including tooth extraction, dental scaling/polishing, and endodontic therapy are necessary.

What are the oral complication of head and neck radiation?

The oral complication of head and neck radiation can be divided into two groups based on the actual time of their occurrence. Acute complication occurs during radiation therapy (RT), and late complication occurs after RT has completed. The anatomy and physiology of this region are unique and complex. Function and appearance are critical to patients images quality-of-life, most patients with head and neck squamous cell carcinoma are middle-aged, adult males in lower socioeconomic classes who are chronic tobacco chewer and alcohol consumers have advanced tumors. These patients tend to less conscious and to have less social support then most cancer patients.

What are the complications of RT?

One of the earliest complications of RT is the development of mucositis. The soft tissues in the treatment field after a week or two demonstrate a moderate amount of erythema. As the radiation continues, the mucosa may exhibit varying degree of desquamation and frank ulceration, resulting in pain and dysphagia which makes patients to eat a well-balanced diet leading to significant weight loss and malnutrition.[8] Mucositis is common life-threatening acute adverse effect due to early changes in the oral mucosal tissue which is extremely is sensitive to radiation dose.[9] The development of mucositis depends on the dose of radiation, angulations to the beam location of tumor and the degree of oral hygiene, mucositis can occur anywhere there is oral mucosa including the oral cavity, esophagus, larynx, and pharynx, clinically, the oral mucositis appear to be due to epithelial thinning and vasodilatation. This can lead to ulceration or mouth sores, sloughing of the epithelium, and crusting of lips. Oral mucositis causes serve pain and increases the risk for the development of systemic infection from bacterial, fungal, or viral infection in the mouth.[10]

What is the best treatment for plague?

Perform a complete prophylaxis with a fluoride treatment and home care instruction for plague control[5]

What is the goal of a dental evaluation?

The goal of this evaluation is to identify teeth at significant risk of infection broken teeth that would optimally require aggressive or invasive dental treatment during and after the radiation that increases the risk of soft time necrosis and osteonecrosis

What is the standard unit of radiation?

Radiation doses are expressed in the standard unit the gray (Gy) which is defined as J/kg.[5] Rothwell states that most orofacial complications are dose dependent and that severe side effect occurs when doses <45 Gy administered be the bilaterally to the mouth, jaws, and salivary gland.[5]

Is papilloma a risk factor for oral cancer?

Human papilloma virus especially types 16 and 18 are known risk factors ( there are over 100 variables) and independent causative factor for oral cancer.[4] Tobacco and alcohol are strong synergistic effects or oral cancer. There are strong synergistic effects on oral cancer risk when a person is both (smoker and drinker) tobacco use including smokeless tobacco excessive intake of alcohol intake estimated to account for about 90% of oral cancers.[3]

How to treat sore mouth after radiation?

Treatment of sore mouth. Your mouth may become too painful to clean during radiation treatment. If this happens, contact the dental clinic. The staff will help you with methods of dealing with the discomfort by suggesting easier ways to keep your teeth clean. They can also recommend rinses that help relieve pain.

What to do if your teeth are sensitive?

If your teeth become sensitive or you have any concerns with your mouth, you should contact the dental clinic or your dentist. * To reduce the risk of tooth break-down, continue to use the fluoride in the custom gel carriers. This will be necessary as long as your mouth remains dry.

How to get rid of sticky saliva in mouth?

If you have thick, sticky saliva in your mouth, rinse with a mixture of baking soda, salt and water (1/2 tsp. baking soda, 1/4 tsp. salt, and 500 ml water). Visit a dentist regularly. Dry mouth can be permanent.

How to help dry mouth?

Care of dry mouth. Most people find sipping water from a bottle is the best method to help moisten their mouth. Chewing sugarless gum or sucking on sugarless hard candies may help stimulate saliva. Avoid frequent eating of soft carbohydrate foods and drinks with sugar or honey as these can cause tooth breakdown.

How to get rid of sore mouth from gel?

Put enough gel in the tray to cover the teeth. If gel over flows from tray when placed in your mouth, you have put too much gel in the tray. Wear the trays for one minute . After you remove the trays from your mouth rinse them with cool water and let them air dry. Treatment of sore mouth.

Can you use fluoride in a custom made tray?

From impressions taken of your teeth clear plastic custom gel trays are made. Once daily, place a small amount of fluoride gel in each tray. Put enough gel in the tray to cover the teeth.

How long does it take for saliva to change after radiation?

The changes in saliva will appear within a week or two after starting radiation treatment. Your mouth and throat may also become sore. To reduce problems from changes in saliva and soreness in the mouth, it is important to follow instructions given by dental and medical professionals.

Why is it important to see a dentist after a cancer diagnosis?

That’s why it is important to try to see your dentist soon after your diagnosis so that you may potentially treat any existing gum disease before undergoing cancer treatment.

How does radiation affect your body?

Chemotherapy and radiation work to destroy rapidly growing cells throughout your body. Unfortunately some healthy cells are affected in the process – including the cells in your mouth. Also because your immune system is low, your mouth is vulnerable to infection.

How to treat dry mouth?

Get a dental checkup and talk to your doctor about treatment options. They may recommend the use of artificial saliva and/or a fluoride rinse or gel which may reduce tooth decay caused by dry mouth. Brush Your Te eth. Brush your teeth twice a day with fluoride toothpaste.

How to get rid of sores in mouth?

This includes alcohol-based mouth rinses and alcoholic drinks which can burn mouth sores. Rinse Your Mouth Often. This will help keep food and debris off of your teeth and gums. Rinsing often, along with regular brushing and flossing, may help to reduce the chance of dental decay and infection.

How to make your tongue soft?

Brush twice a day with fluoride toothpaste. You can soak your extra-soft toothbrush in warm water to make it softer. Don’t forget to brush your tongue!

How to treat sores in mouth from a swollen tooth?

They may be able to recommend topical treatments that can include coating agents which form a film to protect the sores or painkillers which can numb the sores in your mouth. Be careful when eating or brushing your teeth while taking numbing medication since you may not be able to feel if you are causing more damage. There are also over-the-counter products, such as fluoride toothpastes, that contain aloe vera and allantoin, which claim to be naturally soothing and gentle. Talk to your dentist about using these products.

What to do if you have a sore in your mouth?

An infection in your mouth can present itself in different ways. According to the NIDCR, you should contact your cancer care team if you see a sore, or a sticky, white film in your mouth or if you experience swelling or bleeding.

How to clean your mouth after radiation treatment?

Overall Dental Care after Radiation Therapy. Keep your mouth clean. Use fluoride daily. Rinse your mouth frequently during radiation treatment to reduce soreness of the oral tissues and to prevent infection. Rinse with a dilute solution of 1 tablespoon baking soda in one quart of water.

What is the condition that often affects the mouth and throat following radiation therapy?

The inflammatory condition that often affects the mouth and throat following radiation therapy is termed mucositis.

Why is it important to practice jaw exercises?

If you are instructed to practice jaw exercises or if you have been prescribed a device such as a Thera-bite, it is important that you comply with all of your instructions in order to maintain your jaw mobility, flexibility, and function. These exercises may be used to help treat restricted jaw range of motion, known as trismus, which is a side effect of radiation therapy.

How long should you wait to eat after removing fluoride?

After removal of the fluoride carriers or after brushing on your fluoride, do not rinse, eat or drink for 30 minutes. This helps to prolong the duration of the contact of the gel with the teeth and gums.

How long should you leave fluoride gel in a case?

It is suggested that this be done prior to bedtime. If you have been instructed to use fluoride carriers, then following the 10 minute period of application, the carrier should be removed and rinsed with cool water to wash away the residue fluoride gel. Store them inside the case in a cool place until the next morning.

How to clean teeth with a prosthesis?

Brush your teeth thoroughly with a non-irritating toothbrush and toothpaste of your choice. Floss your teeth carefully and avoid irritating your gums. If you have a dental prosthesis, remove it and clean it with a mild liquid soap and water.

Can Xerostomia cause decay?

Xerostomia or “dry mouth” can cause your teeth to first become sensitive and then to decay, unless they are properly protected. Radiation therapy also has a permanent damaging effect on the portion of the jawbone that receives radiation. This effect permanently reduces the bone’s ability to heal and resist infection.

Why is dental care important for radiation patients?

Dental care is an important consideration for radiation therapy patients for several reasons: (1) head and neck cancer patients who have excellent oral health are less likely to have severe complications from their cancer radiation therapy than those patients in poor oral health 1; (2) dental treatment before, during, and after radiation therapy requires special considerations; and (3) radiation therapy to the head and neck region is associated with specific oral pathology. 2

How to reduce radiation caries?

In some patients, the risk of radiation caries may be reduced by meticulous oral hygiene, daily topical fluoride applications at home, and frequent professional dental care. A home-care regimen recommended to patients is the following:

Can radiation cause soft tissue necrosis?

Soft-tissue necrosis. Ischemia of the oral tissues following radiation therapy may increase the incidence of sloughing of the soft tissues of the oral cavity . This problem usually localizes to the site of pre-existing periodontal lesions or as the result of denture irritation. Such soft-tissue necroses may precede osteoradionecrosis. Appropriate denture care and/or periodontal care may prevent this complication.

Can you use HBO after tooth extraction?

If extractions are unavoidable from regions receiving more than 5,000 cGy, one long-established protocol recommends that HBO be considered prior to and after extractions. 12 Other clinicians rarely prescribe HBO therapy . 13

What is the term for a dry mouth after radiation?

Xerostomia. Dry mouth frequently occurs during and after radiation therapy, especially when the parotid glands and the submandibular glands are directly in the field of irradiation. Associated with xerostomia is a shift in the pH in the mouth toward a more acidic environment (pH 5.5 or less) and a highly cariogenic oral flora. Under these conditions, the teeth rapidly demineralize, especially in the cervical and incisal/occlusal surfaces. This demineralization is termed “radiation caries” (Figures 2 and 3). Radiation caries may involve all of the remaining teeth, not just those in the direct line of radiation.

Does radiation affect taste?

Loss of taste (dysgeusia). Many patients experience a change in taste or a complete loss of taste during radiation therapy. The loss of “salt” perception is particularly problematic, since patients tend to add significant quantities of salt to bland-tasting food, with potential effects on blood pressure. Taste perception often improves approximately 4 months after the completion of radiation therapy. Zinc sulfate supplements may increase taste perception and improve salivation. 8

Can radiation beams cause mucositis?

Back-scatter of the radiation beam due to a metal dental restoration may create a localized mucositis, especially on the buccal mucosa or tongue. Many radiation oncologists recommend the fabrication of custom acrylic bite blocks covering teeth that have metallic restorations, using flanges to displace the tongue and buccal tissues.

What to do for a head and neck radiation?

The radiation oncologist or dentist will prescribe antiviral and antifungal medications when appropriate. These medications are usually very effective in lowering the risk of viral and fungal (thrush) infections in the mouth.

How to clean dentures without metal?

Dentures without metal may be soaked daily in a fresh solution of Clorox and water (1 tbs. Clorox to 1/2 cup of water). Rinse the dentures well before placing them back in the mouth.

How to get rid of dry mouth and sores?

Saline or saltwater and baking soda rinses (1 tsp. salt and 1 tsp. baking soda to one quart of water) may be used throughout the day to sooth the sore and dry mouth. When using mouthrinses, be sure to stagger their use throughout the day, allowing at least one hour before another mouthrinse.

Can you use a water irrigating toothbrush to remove food between teeth?

Flossing is recommended as well as the use of a water-irrigating device, on a low setting, to eliminate food between teeth. Hint: The bristles of the supersoft toothbrush will become even softer if held under warm water before use.

Is it important to clean your mouth during radiation?

It is extremely important to keep the mouth clean and healthy during head and neck radiation, to help reduce the risk of oral infection. A professional dental cleaning prior to radiation is highly recommended. Following are some suggestions for reducing oral complications during head and neck radiation.

How to treat mouth ulcers?

To ease the pain of mouth ulcers, rinse with viscous lidocaine about 15 minutes before eating. Some pharmacies can also make flavored lollipops with medications that have a numbing effect (tetracaine) to use before eating. Eat small bites and chew thoroughly when using these numbing medicines to reduce the risk of choking .

Can you rinse your dentures before placing them back in your mouth?

Rinse the dentures well before placing them back in the mouth. *Biotene supersoft toothbrush, mouthrin se without alcohol, water-based lubricant (OralBalance) and toothpaste are specially made for people with dry and sore mouths. They can be obtained through most pharmacies and are over-the-counter.