See your dentist before starting radiation therapy. If you are having carious teeth then you might need dental extraction or filling of teeth. If dental extraction is planned then it should be done 1 week before starting radiation therapy to give time for wound healing. If dental extraction is done after completing radiation then there is more chance of osteoradionecrosis of bone. Osteoradionecrosis of bone means infection and lack of blood supply to bone leading to damage or wound in the bone.
If you have any sharp teeth then it should be smoothened to prevent friction and injury to oral mucosa. You might also need scaling and cleaning of teeth. Brush teeth 3 times a day. Use soft toothbrush for brushing. Use floss once daily. If you are having bleeding then don’t use floss. Rinse your mouth after every meal to avoid accumulation of food particles in the mouth. If you are not able to brush your teeth due to oral ulcers then I recommend you to use sponge applicator or toothette to brush your teeth. I recommend to use fluoride containing toothpaste. I also recommend to apply fluoride gel on teeth once a day. This will prevent dental caries.If you are having dentures then use it only at the time of eating. Wearing it for long time may cause friction and injury to gum.
If you are having pain after wearing denture then I advise to not to use denture and take only liquid or semisolid food which is ready to drink. Whenever patient is getting radiation to mouth area the acidity of mouth area increases and in acidic medium there is more growth of bacteria leading to infection of oral cavity. To avoid the acidity of oral cavity we advise patient to do gargling with salt and soda water. To make salt and soda water you need to take 1 L water and add 1 tablespoon of salt and Half tablespoon of baking soda. Mix the solution properly and rinse the mouth 6 to 8 times a day. It will decrease acidity of your mouth and prevent bacterial infection. This is one of the most important precaution during radiation therapy. Avoid using alcohol containing mouth washes during radiation therapy as it can cause dryness of mouth. If you are having difficulty in swallowing due to mouth ulcers then your doctor might suggest you to take local anesthetic syrups like Xylocaine. You need to take 10 to 15 ML of syrup five minutes before taking food and you need to make sure that xylocaine liquid touches all the parts of oral cavity so that it will cause anesthesia of oral mucosa and decrease the pain during swallowing.
If you are having whitish patches over oral mucosa then you should consult your oncologist as there is possibility of fungal infection inside mouth. Avoid spicy and food that is difficult to chew during radiation therapy. Avoid irritating foods like citrus fruits, carbonated drinks and alcoholic beverages. Don’t take hot food like hot tea or coffee. If you are feeling dryness of mouth you are a doctor might prescribe new artificial saliva spray or gel. Apply this in oral cavity 2 to 4 times a day.You need to continue oral hygiene measures even after completing radiation therapy. In case there is a need of dental extraction after completing radiation
therapy then tell your dentist to consult your oncologist before doing the procedure.
