Skip to main content Skip to main menu
UF Health University of Florida
College of Dentistry UNIVERSITY of FLORIDA
hire a gator dentist
Patient Care Overview

Mouth Care for Head and Neck Radiation Therapy Patients

Radiation therapy to the head and neck can affect your teeth, gums, jawbone, saliva, and taste. Good mouth care before, during, and after treatment is very important to prevent serious dental problems that can last a lifetime.

Dental Care Before Head and Neck Radiation

Why a Dental Exam Is Important

Radiation can permanently affect healing of the jawbone. Teeth that are badly damaged or infected may need to be removed before radiation begins. If teeth are removed after radiation, the jaw may not heal properly, which can cause serious complications.

This risk lasts for the rest of your life.

After radiation therapy:

  • Always check with your radiation oncologist before having teeth removed.
  • Always tell your dentist that you have had head and neck radiation.

When to See A Dentist

  • As soon as possible after learning you need radiation therapy to the head and neck
  • A professional dental cleaning 1–2 weeks before radiation starts is recommended
  • If teeth need to be removed:
    • Healing time of at least 2 weeks is needed before radiation starts.

Seeing the dentist early helps prevent delays in cancer treatment.

Fluoride Trays and Tooth Protection

Radiation reduces saliva, which:

  • Allows bacteria to grow.
  • Weakens tooth enamel.

This can lead to severe tooth decay, sometimes within weeks after radiation.

Your dentist will:

  • Take impressions of your teeth.
  • Make custom fluoride trays.
  • Prescribe fluoride gel to use daily.

Daily fluoride use is one of the most important steps to protect your teeth.

Daily Oral Hygiene

Brushing and Cleaning

  • Brush teeth twice a day.
  • Use a super‑soft toothbrush.
  • Brush gently in small circles at the gumline.
  • Brush:
    • All teeth
    • Gums
    • Tongue
    • Roof of mouth
  • Soften toothbrush bristles with warm water before use.
  • Floss daily, gently, if your mouth allows.

Helpful Tools

  • Use a water flosser/irrigating device on a low setting
  • Use children’s toothpaste or dry‑mouth toothpaste if regular toothpaste burns

Toothbrush Care

  • Disinfect toothbrush at least once a week:
    • Soak in fresh bleach solution (1 tablespoon bleach in ½ cup water)
  • Rinse well before using.
  • Replace toothbrush weekly.

Once your mouth is no longer sore, you may return to:

  • Regular soft toothbrush.
  • Electric toothbrush with soft bristles.

Sore Mouth Care

Mouth Rinses

  • Use often throughout the day:
    • 1 tsp salt + 1 tsp baking soda in 1 quart of water
  • If using multiple rinses and fluoride:
    • Space them at least 1 hour apart

Pain Relief

  • Numbing mouth rinses may be prescribed
  • Use 15 minutes before eating
  • Take small bites and chew carefully

Dentures and Lips

  • Remove dentures if your mouth is sore.
  • Do not wear dentures until your mouth heals.
  • Clean dentures daily with antimicrobial cleaner.
  • Dentures without metal may be soaked in bleach solution (1 tablespoon bleach in ½ cup water).
  • Rinse dentures well before wearing.
  • Keep lips moist with water‑based products.
  • Do not use petroleum jelly.
  • Do not apply mouth moisturizers right before radiation treatment.

Burning Mouth or Infection

  • Ongoing burning after radiation may be a fungal infection (thrush).
  • Your doctor or dentist can prescribe treatment.
  • Clean fluoride trays and toothbrush daily.
  • Eating yogurt may help restore healthy mouth bacteria.

Dry Mouth Management

Dry mouth is very common during and after radiation.

Helpful Tips

  • Sip water throughout the day.
  • Sip liquids with meals.
  • Choose soft, moist, or blended foods.
  • Use sugar‑free gum or candy.
  • Try artificial saliva products.
  • Water with a few drops of glycerin may help.

Medications

  • Pilocarpine (Salagen®) may help increase saliva for some patients (prescription required).

Avoid

  • Alcohol‑based mouthwashes
  • Tobacco products
  • Alcohol
  • Sugary foods and drinks
  • Sharp or crunchy foods (chips, crackers)
  • Toothpicks (ask your dentist about small brushes to clean between teeth).

Taste Changes

  • Taste loss is common.
  • Most people gradually improve.
  • Taste often returns 4–6 months after radiation ends.

Mouth Care After Radiation Therapy

  • Dental cleanings every 3–6 months.
  • Dental X‑rays every 6–12 months.
  • Use fluoride every day for life.

Why Fluoride Trays Are So Important

Radiation permanently changes saliva. Without fluoride:

  • Teeth can decay very quickly
  • All teeth can be damaged in a short time

Daily fluoride helps protect teeth from decay caused by dry mouth.

Recommended Fluoride

  • Prescription 1.1% sodium fluoride.

How to Use Fluoride Trays

  1. Use fluoride at bedtime
  2. Remove dentures
  3. Brush and floss teeth thoroughly
  4. Place a thin ribbon of fluoride gel into trays
  5. Insert trays and leave in place 5–10 minutes
  6. Remove trays and spit out fluoride
  7. Do NOT rinse, eat, or drink for 30 minutes
  • Start fluoride within 1 week after radiation ends.
  • Use fluoride every day for the rest of your life.

Care of Fluoride Trays

  • Rinse and dry trays after each use.
  • Clean with:
    • Toothbrush and toothpaste, or
    • Denture cleaner.
  • Occasionally disinfect:
    • Soak in bleach solution (1 tablespoon bleach in ½ cup water) for 15 minutes.
  • For hard water buildup:
    • Soak in white vinegar overnight, then brush.
  • Do NOT use hot water or heat when cleaning trays.

This patient information was developed by the

UF Health Oral Medicine Clinic

P.O. Box 100414, Gainesville, FL 32610

352-273-6741