Oral Care During Head & Neck Radiotherapy

It is extremely important to keep the mouth clean and healthy during head and neck radiation, to help reduce the risk of oral infection. A professional dental cleaning prior to radiation is highly recommended. Following are some suggestions for reducing oral complications during head and neck radiation.

  1. The radiation oncologist or dentist will prescribe antiviral and antifungal medications when appropriate. These medications are usually very effective in lowering the risk of viral and fungal (thrush) infections in the mouth. Fewer infections in the mouth results in less pain and better nutrition.
  2. Toothbrushing should be performed at least twice daily. Supersoft toothbrushes* are available that will not cause irritation, if used appropriately. Brushing should be done in agentle, circular motion. To be thorough, brush teeth in a systematic fashion to include all surfaces of every tooth. Flossing is recommended as well as the use of a water-irrigating device, on a low setting, to eliminate food between teeth.

    Hint: The bristles of the supersoft toothbrush will become even softer if held under warm water before use.

    Hint: It is a good idea to gently brush the tongue, palate and gums with a supersoft toothbrush on a daily basis in order to remove harmful germs.

    Hint: If a particular toothpaste burns or irritates the mouth, try a toothpaste that is specially made for children or people with dry mouth.*

  3. Saline or saltwater and baking soda rinses (1 tsp. salt and 1 tsp. baking soda to one quart of water) may be used throughout the day to sooth the sore and dry mouth. When using mouthrinses, be sure to stagger their use throughout the day, allowing at least one hour before another mouthrinse. Using several different mouthrinses at one time will reduce their effectiveness.
  4. To ease the pain of mouth ulcers, rinse with viscous lidocaine about 15 minutes before eating. Some pharmacies can also make flavored lollipops with medications that have a numbing effect (tetracaine) to use before eating. Eat small bites and chew thoroughly when using these numbing medicines to reduce the risk of choking.
  5. Keep mouth and lips well lubricated with a water-based lubricant*. Petroleum jelly repels water and is not recommended for use.
  6. When the mouth is sore, remove dentures and leave them out until the mouth heals. All full dentures and partial dentures should be disinfected before each use. Dentures without metal may be soaked daily in a fresh solution of Clorox and water (1 tbs. Clorox to 1/2 cup of water). Rinse the dentures well before placing them back in the mouth.

*Biotene supersoft toothbrush, mouthrinse without alcohol, water-based lubricant (OralBalance) and toothpaste are specially made for people with dry and sore mouths. They can be obtained through most pharmacies and are over-the-counter. The manufacturer of these products is Laclede , 15011 Staff Court, Gardena, CA 90248, 1-800-922-5856.