If you are going to have radiation therapy for cancer of the head or neck, your oral exam play an important part of your therapy. One month before therapy, there will be an oral health examination and prophylaxis. Any necessary dental treatment will be scheduled in consultation with the radiation oncologist. Present or potential problem teeth in the proposed radiation field will be extracted, allowing at least 14 days of healing for any oral surgical procedure. To prevent tooth demineralization and radiation decay, custom carrier trays will be fabricated to cover all tooth structures for daily home application of fluoride gel, beginning before the initiation of therapy. Close attention is paid to keeping your teeth clean, your mouth moist, and watching for any signs of tissue irritation or infection. Sometimes it is advisable to not wear any removable appliances during this period. For the first six months, cleaning can be necessary as often as every 4 to 8 weeks. Muscle exercises may be useful for painful or weak chewing muscles. Continued fluoride application for remaining teeth is recommended if dry mouth persists, even if this is a lifelong effort. Use of dentures or other removable appliances may be limited by the friability of the tissues. Any tooth extraction or surgery on irradiated bone should be conservative, using antibiotic coverage and possible hyperbaric oxygen therapy.
Robert G. Tupac, DDS, FACP, Inc., Diplomate, American Board of Prosthodontics (661) 325-1275 | www.drtupac.com 5060 California Ave., #170, Bakersfield, CA 93309