Radiation Therapy

Caries Prevention Strategy

Radiation treatment to the head and neck region presents many dental challenges. Some changes to the oral environment will occur immediately and others later. Early on, you may experience dermatitis, mucositis, and partially or severely reduced salivary flow with resulting xerostomia (dry-mouth). Other minor affects, such as pressure & temperature sensitivities, unpleasant odor and taste, bleeding, tenderness, plaque accumulation. A major concern is a susceptibility to rapid tooth decay. We can help guide you through this.

Step 1: Exam, Cleaning, and X-rays Prior to Radiation Therapy

We recommend a thorough exam to ensure that all dental needs are identified and treated prior to radiation

Step 2: Complete necessary Dental Treatment and Fabrication of Fluoride Gel Tray Carriers

We will give you a prescription strength fluoride gel for your trays and prescription fluoride toothpaste for morning use. We recommend a non-alcoholic mouthwash, such as Crest ProHealth for mid-day use. Instructions for Gel Trays are below.

Step 3: Dietary Counseling

You will need to alter your diet to softer, less spicy, lower sugar (or non-sugar) foods eaten at moderate temperatures and with large amounts of sugar-free liquids with meals. Alcohol and tobacco products must absolutely be avoided. Depending upon severity of xerostomia, we may give you a Pilocarpine prescription to help induce salivary flow. Frequent sipping of water will be very helpful also.

Step 4: Monthly Follow-Up visits to evaluate any changes 

Fluoride Gel Tray Carriers

NeutraCare 1.1% Sodium Fluoride Gel

Patient Instructions for Gel Fluoride Trays:

1. Brush and floss gently to thoroughly remove all bacterial plaque possible.
2. Use Prepared custom-made tray. Load the tray by distributing approximately 5 drops of the gel around each tray.
3. Dry the mouth by swallowing several times.
4. Apply the tray(s) over the teeth and press gently to seat. Wipe away any excess with finger tip, and use less next time if excessive overflow. Hold head upright.
5. Time by a clock for 5 minutes. DO NOT SWALLOW.
6. Expectorate (spit) several times when the trays are removed.
7. Do not eat or drink for 30 minutes. One application should be made before bed each night.
8. Gently clean them with lukewarm water (NOT HOT) and a Q-tip to remove residue.