The mouth is one of the most complex parts of the body. It consists of many delicate cells and tissues which function together. It is also one of the prime areas of the body that reflects changes specific to systemic disease. Often, cancer therapy can interfere with the functions of the oral tissues. Cancer therapy includes a combination of chemotherapy and radiation. Radiation therapy uses high energy waves that destroy the tumor producing cells without causing any harm to the surrounding healthy tissue.
Although radiation therapy is a useful cancer treatment, it can have some side effects on the oral tissues. The severity of the symptoms depends upon the dose, duration of the radiation used, and the part of the body being treated. Some of the oral effects of radiation therapy include dry mouth, radiation caries, loss of taste, sore mouth, oral infections, jaw stiffness, and bony changes in the jaw.
An individual may experience few to all of these oral effects. However, you can keep a check on your oral condition and take care of your oral health by following preventive dental care. Today’s article will highlight some of the characteristic radiation effects on oral tissues and preventive measures that can help you to keep these symptoms in control.
What is radiation therapy?
Radiation therapy is one of the most common types of cancer treatment which uses high energy beams to destroy the cancer cells in the body. These energy beams may consist of x-rays, photons, or any other type of energy molecules. (1)
Although radiation therapy is ideal for cancerous lesions, some non-cancerous or benign tumors are also treated by radiation therapy. The prime goal of this treatment is to kill the cancer-producing cells while causing minimal to harm to the surrounding healthy tissue.
What effects does radiation therapy have on oral health?
The oral cavity is often affected in several ways by radiation therapy. Some of these side effects may resolve after the completion of the treatment while some oral effects may last for a long time. Most common oral effects of radiation therapy are as follows –
Salivary glands are one of the most radiosensitive tissues in the mouth. Often, radiation therapy affects the production of saliva in the mouth. As a result, the person may experience difficulty in chewing and swallowing. (2)
After the completion of cancer treatment, salivary production may take at least 7-10 days to get back to normal. However, if the area for radiation therapy directly includes salivary glands, the patient may experience permanent dry mouth even after the treatment is completed.
Just like the salivary glands, the mucosal cell lining of the mouth is also sensitive to radiation. This makes the mucosal tissue susceptible to radiation damage. Often, these effects reflect in the form of oral ulcers, collectively called as oral mucositis. These lesions appear after a week of radiation therapy. The soreness caused by the ulcers lasts until the radiation treatment is completed. However, in some cases, it may be prolonged for a few weeks after the completion of the procedure.
Any tissue compromise makes it susceptible to diseases. Oral tissues become prone to bacterial and fungal infections during radiation therapy. Bacteria infections are mainly caused as a side effect of dry mouth. Additionally, radiation therapy alters the oral habitat and increases the risk of fungal infection like oral thrush and candidiasis.
Radiotherapy often affects the taste buds by blocking the functions of the taste receptors. Often, radiation therapy produces a metallic taste in the mouth. Many patients may complain that all types of food taste similar. Loss of taste may subside more quickly than the other side effects of radiotherapy. (3)
A cumulative effect of radiation therapy, dry mouth, and bacterial accumulation causes tooth decay and gum disease. Radiation caries is a rapid form of tooth decay that can only be healed with accurate diagnosis and prompt treatment. (4)
What can your dentist do to help?
Cancer therapy is a challenging time for a patient. Therefore, it is crucial to visit the dentist at least four weeks before starting radiotherapy. Early dental consultation will rule out any current tooth decay or oral condition. Treating an existing dental problem well before the radiation treatment will help to prevent severe complications. All dental surgeries should be completed at least two weeks before radiation or chemotherapy. (5)
Additionally, your dentist can educate you on the common side effects of radiation therapy and tech your some preventive dental routines that will help you to maintain your oral health.
How can you maintain your oral health during radiation therapy?
Oral health maintenance is crucial during radiation therapy. Following are some of the preventive measures that will maintain the health of your oral tissues –
- Keep a check on the type of food and drinks you consume. Avoid spicy and dry food, alcoholic beverages, and very hot food or beverages. Instead, switch to a balanced nutritious diet that consists of fresh fruits, vegetables, and dairy products.
- Drink plenty of water and keep your self hydrated to prevent dry mouth. Sugar-free chewing gums can also help to stimulate salivary flow. (6)
- Dry and sore mouth often causes trouble in chewing and swallowing. Use alcohol-free, antimicrobial mouthwash to keep your mouth fresh and moist.
- Follow regular dental care by brushing two times day followed by flossing at least once in a day to reduce plaque and bacteria in the mouth.
- Smoking worsens the soreness of the mouth. Try to cut down or quit smoking altogether. Talk to your doctor about nicotine replacement treatments.
- Another reason for the sore mouth is the continuous use of dentures during the therapy. You might find it comfortable to take the dentures out for some time during the day.
Take away message
If you are undergoing treatment for cancer therapy, oral health may seem like the least priority. However, it is one of the most crucial parts of our body that reflects the changes happening in the body. Radiation therapy is done to kill the cancer cells with a beam of high energy x-rays, photons, or other energy molecules.
Oral tissues are highly radio-sensitive and have a high risk of undergoing temporary or permanent changes while the patient is treated with radiation. Several factors like the dose and duration of the radiation, and the part of the body being treated may affect the severity of oral symptoms. Some of the common oral effects of radiation therapy include dry mouth, soreness of the mouth, tooth decay, jaw stiffness, taste alterations, and oral infections.
Dental counseling and preventive dental care can take you a long way maintaining the health of your oral tissues. Additionally, having good knowledge about the potential risk of radiation therapy can benefit you to stay healthy throughout the treatment.