Head and Neck Reconstructive Services
This leaflet is to provide you with advice and guidance regarding dental and mouth care whilst you are undergoing treatment for head and neck cancer. If you have any concerns or questions which are not answered in this leaflet, please speak to your healthcare professional.
Why am I having a dental assessment?
Cancer treatment to treat head and neck cancer affects the mouth and jaw. It is very important that your mouth is healthy and is maintained, this is to avoid delays in your cancer treatment due to any dental problems.
If you require surgery this can change the shape of your mouth and can affect your:
The side effects of head and neck cancer treatments can affect your:
Side effects can be experienced both at the same time and later.
As part of your care, we will need to assess your mouth at an early stage before your treatment starts. This helps us to plan for any treatment you will need once your cancer treatment has finished.
Complications: During and after treatment
Mucositis or sore mouth
Once you have started chemotherapy or radiotherapy you may experience a sore mouth after one to two weeks. This is quite common and can last for up to six weeks after you have finished your treatment.
Due to your mouth feeling very sore and raw you may feel you cannot brush your teeth properly. Using bland rinses such as warm salt water or sodium bicarbonate often gives some relief.
It is recommended during your treatment you should only use mouthwashes or gels which have been advised or prescribed by your cancer team.
After chemotherapy and, or radiotherapy you are likely to experience having a “dry mouth” due to less saliva, the effect of drugs and radiation on the glands that produce saliva.
Radiotherapy associated tooth decay
Radiotherapy associated tooth decay can develop as a result of dry mouth in combination with eating sugary foods. Widespread tooth decay can happen and this can quickly destroy teeth.
Sometimes after radiotherapy part of your jawbone can erode (die) which can be very painful, last for months and you may need surgery.
Your teeth may need to be extracted (removed) before your radiotherapy starts. If you have your teeth extracted after radiotherapy treatment you are at higher risk of your jawbone being affected.
Limited mouth opening
You may experience limited mouth opening after surgery, radiotherapy, or chemotherapy. Teeth that are near the back of your mouth may not be able to be treated by a dentist due to you not being able to open your mouth fully. You may be advised to have teeth removed before your treatment due to this risk.
Changes to your mouth
Unfortunately, due to the effects of your cancer treatment you may have less teeth to chew with and your speech, swallowing and appearance can also be affected. It may also be much harder for you to undergo some dental treatment and to wear dentures.
This means that your future dental care may sometimes be shared between your own dentist together with one or more of the consultants at James Cook University Hospital and linked support services.
What can I do to help myself?
Visit your dentist regularly so problems can be dealt with at an early stage. If you do not have a dentist, you will need to register with one.
- Ensure you brush your teeth well and clean between your teeth.
- Eating less sugar is best. If you have problems maintaining your weight it will be necessary to get advice from the dietician.
- Your dentist should prescribe higher dose fluoride toothpaste to reduce the risk of radiotherapy associated tooth decay.
- You should use an alcohol-free fluoride mouth rinse at a different time of day from when you brush your teeth.
- If you have a very dry mouth, you should ask your dentist about using saliva replacement therapy/use of frequent saline rinses.
- Smoking is damaging to both dental and general health. If you do smoke you should stop smoking as soon as possible. Smoking cessation advice is available free from your own GP and the South Tees Stop Smoking service which is available at www.stopsmokingsouthtees.co.uk where you can find support.
- Please speak to a member of the team if you would like help with this.
After your head and neck cancer treatment
Given the difficulties that you may encounter after cancer treatment sometimes your dental treatment may not be able to be carried out by just your own dentist. You may need specialist services provided by the hospital dentists or surgeons.
If you are having difficulties with your mouth after your cancer treatment and wish for further advice please contact:
They will try to advise you further and if required refer you to the most appropriate health professional for further management.
South Tees Hospitals NHS Foundation Trust would like your feedback. If you wish to share your experience about your care and treatment or on behalf of a patient, please contact The Patient Experience Department who will advise you on how best to do this.
This service is based at The James Cook University Hospital but also covers the Friarage Hospital in Northallerton, our community hospitals and community health services.