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

Preventing and Treating Oral Complications Before Chemotherapy or Radiation Therapy Begins

Finding and treating oral problems before cancer treatment begins can prevent oral complications or make them less severe.

Problems such as cavities, broken teeth, loose crowns or fillings, and gum disease can get worse or cause problems during cancer treatment. Bacteria live in the mouth and may cause an infection when the immune system is not working well or when white blood cell counts are low. If dental problems are treated before cancer treatments begin, there may be fewer or milder oral complications.

Prevention of oral complications includes a healthy diet, good oral care, and dental checkups.

Ways to prevent oral complications include the following:

  • Eat a well-balanced diet. Healthy eating can help the body stand the stress of cancer treatment, help keep up your energy, fight infection, and rebuild tissue.
  • Keep your mouth and teeth clean. This helps prevent cavities, mouth sores, and infections.
  • Have a complete oral health exam.

    Your dentist should be part of your cancer care team. It is important to choose a dentist who has experience treating patients with oral complications of cancer treatment. A checkup of your oral health at least a month before cancer treatment begins usually allows enough time for the mouth to heal if any dental work is needed. The dentist will treat teeth that have a risk of infection or decay. This will help avoid the need for dental treatments during cancer treatment. Preventive care may help lessen dry mouth, which is a common complication of radiation therapy to the head or neck.

    A preventive oral health exam will check for the following:

    • Mouth sores or infections.
    • Tooth decay.
    • Gum disease.
    • Dentures that do not fit well.
    • Problems moving the jaw.
    • Problems with the salivary glands.

Patients receiving high-dose chemotherapy, stem cell transplant, or radiation therapy should have an oral care plan in place before treatment begins.

The goal of the oral care plan is to find and treat oral disease that may cause complications during treatment and to continue oral care during treatment and recovery. Different oral complications may occur during the different phases of a transplant. Steps can be taken ahead of time to prevent or lessen how severe these side effects will be.

Oral care during radiation therapy will depend on the following:

  • Specific needs of the patient.
  • The radiation dose.
  • The part of the body treated.
  • How long the radiation treatment lasts.
  • Specific complications that occur.

It is important that patients who have head or neck cancer stop smoking.

Continuing to smoke tobacco may slow down recovery. It can also increase the risk that the head or neck cancer will recur or that a second cancer will form. (See the PDQ summary on Smoking in Cancer Care for more information.)

  • Updated: April 24, 2014