Dental problems are common after exposure of the head and neck to radiation therapy.
Radiation affects include:
- Reduced blood supply to the maxillary and mandibular bones.
- Reduced production and changes in the chemical composition of saliva.
- Changes in the bacteria that colonize the mouth.
It is advisable that patients receiving radiation therapy to the head and neck visit their dentist for a thorough oral examination several weeks prior to initiation of the treatment and be examined at a regular annual or semiannual basis throughout life. Getting regular dental cleaning by a dental hygienist or a dentist are also important.
Dental prophylaxis can reduce the risk of developing dental problems leading to bone necrosis. Special fluoride treatments may help to prevent dental problems, along with brushing, flossing, and having one's teeth cleaned regularly.
- Flossing each tooth and brushing with toothpaste after each meal
- Brushing the tongue with a tongue brush or a soft bristled toothbrush once a day
- Rinsing with a baking soda rinse daily. Baking soda helps neutralize the mouth. The rinse is made of one teaspoon ob baking soda added to 12 oz. of water. The baking soda rinse can be used throughout the day.
- Using fluoride in fluoride carriers once a day. These preparation are commercially available and are also custom made by dentists. They are applied over the teeth for 10 minutes. One should not rinse, drink, or eat for 30 minutes after fluoride application.
These ill effects can be reduced by:
- Taking acid reducing medication
- Eating small amounts of food and liquid each time
- Not lying down right after eating
- When lying down, elevate the upper part of the body with a pillow to 45 degrees.
Hyperbaric oxygen therapy
HBO is used to treat a wide range of medical conditions including: bubbles of air in the blood vessels (arterial gas embolism), decompression sickness, carbon monoxide poisoning, a wound that won't heal, a crush injury, gangrene, skin or bone infection causing tissue death (such as osteoradionecrosis), radiation injuries, burns, skin grafts or skin flaps at risk of tissue death, and severe anemia.
HBO therapy is generally safe, and complications are rare. These can include: temporary nearsightedness (myopia), middle ear and inner ear injuries (including leaking fluid and eardrum rupture due to increased air pressure), organ damage caused by air pressure changes (barotrauma), and seizures as a result of oxygen toxicity.
HBO therapy can be performed as outpatient procedure and does not require hospitalization. Hospitalized patients may need to be transported to and from the HBO therapy site if it is an outside facility.