Head And Neck Radiation Treatment & Your Mouth

Are You Being Treated With Radiation for Cancer in Your Head or Neck? If so, this information can help you. While head and neck radiation helps treat cancer, it can also cause other things to happen in your mouth called side effects. Some of these problems could cause you to delay or stop treatment. This information will tell you ways to help prevent mouth problems so you'll get the most from your cancer treatment.

To help prevent serious problems, see a dentist at least two weeks before starting radiation.

How Does Head and Neck Radiation Affect the Mouth?

Doctors use head and neck radiation to treat cancer because it kills cancer cells. But radiation to the head and neck can harm normal cells, including cells in the mouth. Side effects include problems with your teeth and gums; the soft, moist lining of your mouth; glands that make saliva (spit); and jaw bones.

• The side effects can hurt and make it hard to eat, talk, and swallow
• You are more likely to get an infection, which can be dangerous when you are receiving cancer treatment
• If the side effects are bad, you may not be able to keep up with your cancer treatment. Your doctor may need to cut back on your cancer treatment or may even stop it

What Mouth Problems Does Head and Neck Radiation Cause?

You may have certain side effects in your mouth from head and neck radiation. Another person may have different problems. Some problems go away after treatment. Others last a long time, while some may never go away.

• Dry mouth
  
• A lot of cavities
  
• Loss of taste
  
• Sore mouth and gums
  
• Infections
  
• Jaw stiffness
  
• Jaw bone changes

Why should I see a dentist?

• Check your teeth
  
  
• Take x-rays
  
  
• Take care of mouth problems
  
  
• Show you how to take care of your mouth to prevent side effects
  
  
• Show you how to prevent and treat jaw stiffness by exercising the jaw muscles three times a day. Open and close the mouth as far as possible (without causing pain) 20 times

What can I do to keep my mouth healthy?

You can do a lot to keep your mouth healthy during chemotherapy. The first step is to see a dentist beforstrong you start cancer treatment. Once your treatment starts, it's important to look in your mouth every day for sores or other changes. These tips can help prevenstrong and treat a sore mouth:

Keep your mouth moist.

• Drink a lot of water
• Suck ice chips
• Use sugarless gum or sugar-free hard candy
• Use a saliva substitute to help moisten your mouth

Clean your mouth, tongue and gums.

Brush your teeth, gums, and tongue with an extra-soft toothbrush after every meal and at bedtime. If brushing hurts, soften the bristles in warm water

Use a fluoride toothpaste

• Don't use mouthwashes with alcohol in them
• Floss your teeth gently every day. If your gums bleed and hurt, avoid the areas that are bleeding or sore, but keep flossing your other teeth
• Rinse your mouth several times a day with a solution of 1/4 teaspoon baking soda and 1/8 teaspoon salt in one cup of warm water. Follow with a plain water rinse
• Dentures that don't fit well can cause problems. Talk to your cancer doctor or dentist about your dentures

DentalTools

• If your mouth is sore, watch what you eat and drink.
• Choose foods that are good for you and easy to chew and swallow
• Take small bites of food, chew slowly, and sip liquids with your meals
• Eat soft, moist foods such as cooked cereals, mashed potatoes, and scrambled eggs
• If you have trouble swallowing, soften your food with gravy, sauces, broth, yogurt or other liquids

Call your doctor or nurse when your mouth hurts.

• Sharp, crunchy foods, like taco chips, that could scrape or cut your mouth
  
  
• Foods that are hot, spicy, or high in acid, like citrus fruits and juices, which can irritate your mouth
  
  
• Sugary foods, like candy or soda, that could cause cavities
  
  
• Toothpicks, because they can cut your mouth
  
  
• All tobacco products
  
  
• Alcoholic drinks

Do children get mouth problems too?

Remember

The individuals listed here provided assistance in developing, reviewing, and field testing all of the campaign publicationsstrong The campaign sponsors would like to thank them for their contributions.

Scientific Committee

Gerry Barker, R.D.H., M.A.

University of Missouri-Kansas City

Kansas City, MO

Susan L. Beck, R.N., Ph.D., A.O.C.N.

University of Utah

Salt Lake City, UT

Marylin Dodd, R.N., Ph.D.

University of California, San Francisco

San Francisco, CA

Joel Epstein, D.M.D., M.S.D., F.R.C.D.

University of Washington

Seattle, WA

Philip Fox, D.D.S.

Bethesda, MD

Deborah McGuire, R.N., Ph.D.
University of Pennsylvania
Philadelphia, PA

Douglas Peterson, D.M.D., Ph.D.
University of Connecticut
Farmington, CT

Mark M. Schubert, D.D.S., M.S.D.
University of Washington
Seattle, WA

John Wingard, M.D.
University of Florida
Gainesville, FL

Field Testers

Olubunmi Abayomi, M.D.

Howard University Hospital

Washington, DC

Alice Bass, B.S.N., O.C.N.

Greater Southeast Community Hospital

Washington, DC

Betsy Bischoff, R.N., M.S.

Georgetown University Medical Center

Washington, DC

Andrea Bonnick, D.D.S.

Howard University

Washington, DC

Dorothy Chesley, R.N., Ph.D.

Texas Nursing Foundation

Austin, TX

Nancy E. Leupold, M.S.

Support for People with Oral and Head and Neck Cancer (SPOHNC)

Locust Valley, NY

Alice Mahan, B.S., R.T.T.

Howard University Hospital

Washington, DC

MiKaela Olsen, R.N., M.S., O.C.N.

UCSF Stanford Health Care

Stanford, CA

Peter Passero, D.D.S.

Prizm Dental Partners and Management Group

McLean, VA

K. Vendrell Rankin, D.D.S.

Baylor College of Dentistry

Dallas, TX

Oral Health, Cancer Care, and You is an awareness campaign sponsored by the National Institute of Dental and Craniofacial Research (NIDCR) through its National Oral Health Information Clearinghouse (NOHIC). This campaign is being conducted in partnership with the National Cancer Institute, the National Institute of Nursing Research, the Centers for Disease Control and Prevention, and the Friends of the NIDCR.

National Oral Health

Information Clearinghouse

Attn: OCCT

1 NOHIC Way

Bethesda, MD 20892-3500

Fax: 301-907-8830

E-mail: nohic@nidcr.nih.gov

NIH Publication No. 02-4362

• Visit your dentist before your head and neck radiation treatment starts
  
  
• Take good care of your mouth during treatment
  Talk to your dentist about using fluoride gel to help prevent all the cavities that head and neck radiation causes
  
  
• Talk regularly with your cancer doctor and dentist about any mouth problems you have during and after head and neck radiation treatment