Radiotherapy in the head and neck area can play havoc with your teeth with xerostomia or dry mouth being the most common side effect. Your salivary glands are highly susceptible to radiation and if they are affected their full function, generally, will not return.
To counteract Xerostomia, several medications, gels, sugarless chewing gum and sugarless lollies are available. Probably the best approach is to have frequent sips of plain water throughout the day to maintain the moisture inside the mouth. Severe Xerostomia can cause cavities which start at the gum line and strangulate the teeth.
Saliva serves a number of functions for your teeth:
- it washes the teeth, removing food particles, sugars and starches
- it contains antibodies and enzymes that kill or prevent cavity forming bacteria
- it works as a neutraliser for acids produced by plaque bacteria.
Prior to radiotherapy a careful dental examination must be undertaken to determine if any teeth need to be extracted. Any poor or doubtful teeth should be extracted then two to three weeks must elapse after an extraction, especially in the lower jaw, before starting radiotherapy.
To prevent cavities in any remaining teeth, daily fluoride treatment should be employed for the rest of the patient’s life even if some salivary function returns.
Should you ever require a tooth extraction, DO NOT let your dentist perform the extraction without first consulting your radiation oncologist. One possible complication of radiotherapy can be osteoradionecrosis which causes disruptions in the blood supply where a tooth extraction could destroy the jawbone which would then not heal.
Any tooth extraction or other surgery would need to be preceded with hyperbaric oxygen treatment. This increases the blood supply and allows for more successful healing.
To conclude, scrupulous care of your mouth and teeth, before, during and after radiotherapy should help maintain your teeth long after radiation. Make sure that any dentist you see understands the ramifications of your condition and remember that these considerations will prevail for the rest of your life.