The Swallows Australian Edition Magazine

Summary of Oral Care Needed During
Radiation Treatment
• Brush teeth at least twice/day. You may need
to use a special soft toothbrush.
• If toothpaste is too harsh try Biotene
toothpaste (available at pharmacy), or a
children’s toothpaste
• Keep mouth & lips well lubricated with
frequent sips of water & lip moisturizer
• Use a bland mouth rinse such as Saline or
Bi-Carb Soda especially after eating
• Avoid foods which irritate (spicy, dry, acidic,
abrasive)
• Avoid tobacco, alcohol and strong mouthrinse
• If mouth is ulcerated, consider rinsing with
xylocaine viscous 15 minutes before eating.
Over the counter ulcer preparations are also
available.
• Leave dentures out if they are causing
irritation
Long-term side effects of radiation
treatment
The long-term side effects of radiation
treatment which can affect the oral cavity
include
• Dry mouth (xerostomia)
• Rapid decay (radiation caries)
• Poor or no bone healing (osteoradionecrosis)
Dry Mouth
If the salivary glands, particularly the parotid
glands, are damaged from radiation treatment
a rapid and profound reduction in salivary
output and quality occurs. Your saliva may no
longer be able to:
• wash food & debris away
• neutralise acid
• reduce the bacteria which cause decay
• remineralise teeth
If salivary glands are damaged, rapid decay of
the teeth may result. It is more important than
ever for you to look after your oral health.
Rapid Decay
Radiation affects the teeth by weakening the
biological bond between the enamel and
dentine. This means that teeth in the radiation
field have the potential to decay quickly unless
they are being well looked after. This is an
avoidable side effect.
Poor or No Bone Healing
Sometimes bone in the high field of radiation
may lose its ability to heal after trauma. This
condition is called osteoradionecrosis (ORN).
For this reason, dentists will not extract teeth
which have been in a high field of radiation. It is
important that any dentist in the future knows
your radiation history. Your radiation oncologist
will need to be consulted before any tooth
which may have been in the radiation field is
extracted. This remains important for your
lifetime.
ORN can also occur from ill- fitting dentures. If
dentures are rubbing they will need to be
removed. If teeth were extracted prior to
radiation, new dentures must not be
constructed for at least 12 months (lower) and
6 months (upper) following completion of
radiation.
It is important to see a dentist prior to radiation
commencing, so that any poor teeth are
identified and extracted. This will reduce the
need for extractions following radiation.
If soft tissue irritation or ulceration appears in
an area that has received radiation see your
dentist. Also, if you notice an exposed area of
bone at any stage, see your dentist.
Dr Deborah Buick
Principal Dentist Cancer Care
Brisbane Dental Hospital and Adult
Specialist Services
Metro North Hospital and Health Service
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