Head and neck radiation treatment for cancer
The side effects of chemotherapy can be very debilitating but will pass after treatment ceases, but some radiotherapy side effects will be forever
Before starting any radiation treatment a thorough dental examination is needed to identify any potential problems. Once treatment is completed your mouth cleaning has to be fairly obsessive/compulsive to avoid major problems.
One of the long terms effects is the ability of the salivary glands to produce saliva can be seriously reduced. A significant reduction in saliva flow may affect your ability to talk and eat. Reduced saliva means that the mouth cannot buffer the acid that builds up in the mouth from eating and drinking. Bacteria in the mouth convert the food sugars in the foods into acid which softens the tooth surfaces leading to sensitivity and decay. The speed of decay in a dry mouth can be extraordinary so we need to keep a close eye on your mouth from here on - we need to see you every three months.
Once bone has been exposed to radiation treatment any healing after trauma is very, very slow and painful. This means that we NEVER want to damage the bone in that area. If an extraction is required then referral to an Oral Surgeon will be needed and perhaps a trip to Sydney for several sessions in a hyperbaric (oxygen) chamber before the extraction
Extra strong fluoride toothpaste (Neutrafluor 5000) is recommended to really boost the fluoride around the teeth. Tooth Mousse is another product that will help rebuild softened tooth structure
Flexibility of the jaw opening muscles can be reduced so it is advisable to do mouth stretches by opening as wide as possible 10 x day
Mouth rinses with bicarbonate (1 tsp in a glass of water) several times a day will aid in neutralising the acidity in the mouth. If you have ulceration then some salt can be added to the rinse.
Clean between all the teeth using either floss or interdental brushes every night
Use Neutrafluor 5000ppm toothpaste twice a day. Brush all surfaces thoroughly then spit, don’t rinse, to ensure some fluoride is left on the teeth.
If you can’t brush, use a chlorhexidine alcohol free mouth rinse (Curasept)
Tooth mousse at night. Smear a little (small pea size) mousse on the teeth with a finger tip just before going to bed
Daily mouth stretches to increase flexibility
Mouth rinses with bicarbonate/ salt solution several times a day
Sip on water only- no juice or flavourings
Dry mouth gel as required, Biotene and GC make good products
Dental check ups every three months - forever
Sorry this isn’t amusing to read like our other handouts but hopefully informative for those who need it. Good luck and stay obsessed with cleaning.