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Oral Complications of Chemotherapy and Head/Neck Radiation

Prevention and Treatment of Oral Complications Before Chemotherapy and/or Radiation Therapy Begins

Finding and treating oral problems before anticancer therapy begins can prevent or lessen the severity of oral complications.

Oral complications in patients undergoing treatment for head and neck cancer may be reduced by aggressive prevention measures taken before treatment begins. This will get the mouth and teeth in the best possible condition to withstand treatment.

Preventive measures include the following:

The cancer care team should include the patient's dentist. It is important to choose a dentist familiar with the oral side effects of chemotherapy and/or radiation therapy. An evaluation of the patient's oral health at least a month before treatment begins usually provides enough time for the mouth to heal after dental work. The dentist will identify and treat teeth at risk for infection or decay, so the patient may avoid having invasive dental treatment during anticancer therapy. The dentist may also provide appropriate preventive care to lessen the severity of dry mouth, a common complication of radiation therapy to the head and neck.

A preventive oral health exam will check for the following:

Patients undergoing high-dose chemotherapy, stem cell transplant, and/or radiation therapy need 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 produce complications during treatment and to continue oral care throughout treatment and recovery. Different oral complications may occur during the different phases of transplantation. Steps can be taken ahead of time to prevent or lessen the severity of these side effects.

Ongoing oral care during radiation therapy will depend on the specific needs of the patient; the dose, locations, and duration of the radiation treatment; and the specific complications that occur.

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

Continued smoking slows recovery and increases the risk that the head or neck cancer will recur or that a second cancer will develop. (See the PDQ summary on Smoking Cessation and Continued Risk in Cancer Patients for more information.)