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Oral Complications of Chemotherapy and Head/Neck Radiation (PDQ®)

Patient Version
Last Modified: 04/24/2014

General Information About Oral Complications



Oral complications are common in cancer patients, especially those with head and neck cancer.

Complications are new medical problems that occur during or after a disease, procedure, or treatment and that make recovery harder. The complications may be side effects of the disease or treatment, or they may have other causes. Oral complications affect the mouth.

Cancer patients have a high risk of oral complications for a number of reasons:

  • Chemotherapy and radiation therapy slow or stop the growth of new cells.

    These cancer treatments slow or stop the growth of fast growing cells, such as cancer cells. Normal cells in the lining of the mouth also grow quickly, so anticancer treatment can stop them from growing, too. This slows down the ability of oral tissue to repair itself by making new cells.

  • Radiation therapy may directly damage and break down oral tissue, salivary glands, and bone.

  • Chemotherapy and radiation therapy upset the healthy balance of bacteria in the mouth.

    There are many different kinds of bacteria in the mouth. Some are helpful and some are harmful. Chemotherapy and radiation therapy may cause changes in the lining of the mouth and the salivary glands, which make saliva. This can upset the healthy balance of bacteria. These changes may lead to mouth sores, infections, and tooth decay.

This summary is about oral complications caused by chemotherapy and radiation therapy.

Preventing and controlling oral complications can help you continue cancer treatment and have a better quality of life.

Sometimes treatment doses need to be decreased or treatment stopped because of oral complications. Preventive care before cancer treatment begins and treating problems as soon as they appear may make oral complications less severe. When there are fewer complications, cancer treatment may work better and you may have a better quality of life.

Patients receiving treatments that affect the head and neck should have their care planned by a team of doctors and specialists.

To manage oral complications, the oncologist will work closely with your dentist and may refer you to other health professionals with special training. These may include the following specialists:

The goals of oral and dental care are different before, during, and after cancer treatment:

  • Before cancer treatment, the goal is to prepare for cancer treatment by treating existing oral problems.
  • During cancer treatment, the goals are to prevent oral complications and manage problems that occur.
  • After cancer treatment, the goals are to keep teeth and gums healthy and manage any long-term side effects of cancer and its treatment.

The most common oral complications from cancer treatment include the following:

These complications can lead to other problems such as dehydration and malnutrition.