Radiation Therapy and Your Mouth
Feb 21, 2009
Radiation therapy is a common type of treatment for cancer of the head and neck region. There are several important glands in this region called salivary glands. The major function of these important glands is the production of moisture (saliva) in the mouth. When the salivary glands are included in the treatment area, they may be damaged, limiting the amount of saliva produced. This is important because saliva is responsible for a number of important functions in the mouth. As far as teeth are concerned, saliva helps to prevent tooth decay. It also lubricates soft tissues such as the tongue, cheeks, and lips, which helps prevent irritation, which may occur during the normal process of speaking, eating, and swallowing.
Radiation therapy can also affect the jawbones by reducing the size of blood vessels supplying blood to them. Since blood vessels carry cells responsible for defense against bacteria, this can decrease the ability of the jaws to fight infection. Another very important side effect of radiation therapy is that it may cause scar tissue to form in the muscles and joints (temporomandibular joint-TMJ). If this occurs you may not be able to open your mouth to eat normal bites of food or adequately clean your mouth.
These side effects can be classified as short and long term problems. Short-term problems may include infection (bacterial, fungal, or viral), change in taste, pain, bleeding, and inflamed oral tissues commonly called mucositis. Mucositis is similar to a sunburn on your skin. In some patients this may become painful and interfere with eating. Long-term problems include permanent dryness (xerostomia), tooth decay (caries), decrease in the ability to open the mouth wide (fibrosis).
An infection in the jaws called osteoradionecrosis can result in a loss of a portion of bone and tissue covering the bone (ORN, osteoradionecrosis). How severe these problems become is related to the radiation dose, size of the treatment field, degree of mouth dryness, and the quality of the patient's oral hygiene. Prevention and treatment of the complications are discussed in separate areas of this web page (see Oral care Instruction Sheet and Physiotherapy Instruction Sheet).
Radiation therapy can also affect the jawbones by reducing the size of blood vessels supplying blood to them. Since blood vessels carry cells responsible for defense against bacteria, this can decrease the ability of the jaws to fight infection. Another very important side effect of radiation therapy is that it may cause scar tissue to form in the muscles and joints (temporomandibular joint-TMJ). If this occurs you may not be able to open your mouth to eat normal bites of food or adequately clean your mouth.
These side effects can be classified as short and long term problems. Short-term problems may include infection (bacterial, fungal, or viral), change in taste, pain, bleeding, and inflamed oral tissues commonly called mucositis. Mucositis is similar to a sunburn on your skin. In some patients this may become painful and interfere with eating. Long-term problems include permanent dryness (xerostomia), tooth decay (caries), decrease in the ability to open the mouth wide (fibrosis).
An infection in the jaws called osteoradionecrosis can result in a loss of a portion of bone and tissue covering the bone (ORN, osteoradionecrosis). How severe these problems become is related to the radiation dose, size of the treatment field, degree of mouth dryness, and the quality of the patient's oral hygiene. Prevention and treatment of the complications are discussed in separate areas of this web page (see Oral care Instruction Sheet and Physiotherapy Instruction Sheet).
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