Mouth Care During Radiation Therapy to Your Head and Neck

Transcription

1 PATIENT EDUCATION patienteducation.osumc.edu Mouth Care During Radiation Therapy to Your Head and Neck If you are having radiation therapy to your head and/or neck, you need to take special care of your mouth, teeth, and gums. You may not be able to prevent the side effects of treatment, but here are suggestions to help you decrease mouth problems. Possible Side Effects of Radiation Therapy to the Head and Neck Mouth Soreness Soreness and redness of your mouth, tongue and lips may occur. Bleeding of the gums is also possible. Dry Mouth Radiation therapy may damage the glands that make saliva. This damage may make the saliva thick or the mouth dry. Your lips may also become sore and cracked. A dry mouth may make swallowing, eating, and talking difficult. Dry mouth problems may vary in length. Certain medicines may be prescribed to help maintain the flow of saliva and a moist mouth. Taste Changes Changes in the mouth due to radiation may cause foods to taste different. This side effect may be due to damage to your taste buds, a decrease in saliva, or the disease process itself. Changing the types of foods you eat may help. Tooth Decay Poor mouth care and a dry mouth can increase tooth decay. Careful brushing and cleaning of your teeth, along with the use of fluoride This handout is for informational purposes only. Talk with your doctor or health care team if you have any questions about your care. May 26, The Ohio State University Comprehensive Cancer Center Arthur G. James Cancer Hospital and Richard J. Solove Research Institute.

2 gels or trays may help reduce these problems. Fluoride trays are designed to keep fluoride directly against your teeth. Your dentist can make a fluoride tray for you and will teach you how to use your tray. Muscle Tightness The muscles used in chewing may tighten as a result of direct radiation to the face. To help prevent this, exercise your jaw by opening it as wide as possible (like yawning) and then closing it. Do this 20 times and repeat this exercise three or more times a day. If muscle tightness does occur, ask your dentist or radiation oncologist about special exercises you can do to help these muscles. Jaw Infections This is the most serious problem from radiation therapy to the head and neck. It may be caused by gum disease, tooth decay, sores in the mouth, or having your teeth pulled. Talk about any mouth problems with your cancer doctor and dentist. Suggestions to Help Reduce and Cope with These Side Effects 1. Keep your mouth clean and teeth or dentures in good condition: Brush your teeth before and after you eat. Oral care before you eat helps freshen the mouth and may increase your appetite. Use a soft toothbrush with fluoride toothpaste. Try using a child s size toothbrush. It is softer and smaller. The smaller size will help slow down the amount of drainage to the skin inside your mouth. If the bristles hurt the gums, soften them in hot water. Direct the bristles toward the gums and make small strokes in circles. Brush all surfaces. Gently brush your tongue. If your mouth is too sore to use a toothbrush, use gauze or a sponge toothette soaked in warm water to clean your teeth. Floss with waxed dental floss every day if your platelet count is above 50,000. If your platelet count falls below 50,000 your gums may bleed more easily.

3 Use the following mouthwash to rinse your mouth: Mix these together in a glass: 2 teaspoons baking soda 3 teaspoons salt (omit the salt if your mouth burns or you are on a salt restricted diet) 16 ounces water (2 cups of water) If you have a mild sore mouth, rinse every 2 to 3 hours. If you have a severe sore mouth, rinse every 1 to 2 hours with this solution. This solution should be used within 20 minutes of mixing. Swish the mouthwash in your mouth allowing it to go under your tongue. Use a ballooning and sucking cheek motion to force the mouthwash between the teeth. Avoid over the counter mouthwashes. Most over the counter mouthwashes have alcohol in them which dries your mouth. There are over the counter mouthwashes that do not have alcohol in them. Ask your nurse about them. Use the following rinse if you have a heavy amount of debris on your teeth. Mix 1 ounce of 3% hydrogen peroxide and 1 ounce water. Use this rinse three times a day. Use this rinse only for three days. Use fluorides as directed by your dentist to prevent tooth decay. Have a regular dental checkup and keep teeth in good repair. Keep dentures clean and in good repair. Ask your dentist to check your dentures. The tissues in your mouth might change during therapy. This might make the fit of your dentures different. Your dentist might tell you not to wear your dentures during therapy. Brush your dentures every day with a denture brush and liquid detergent. Rinse well. Do not wear dentures at night while sleeping. This will give your gums a chance to rest from the pressure of the dentures and allow for healing of sore tissue.

4 Store the dentures in a clean cup with denture cleaner. Change the solution daily to prevent germs from growing. If you use disposable denture cups, use a new one daily. 2. To lessen pain and dryness: Eat a diet of soft foods. Avoid foods such as citrus fruits and juices, hot, spicy foods, and rough, coarse foods like popcorn, potato chips or pretzels. These foods may cause irritation or burning. Drink water and other non-irritating liquids (such as apple juice, grape juice, fruit aides) several times each hour throughout the day. Use straws when you drink. Melt ice chips in your mouth or use gauze soaked in ice water to relieve soreness. Carry a spray bottle of water to help relieve dryness. Artificial saliva is available over the counter in drug stores. This product may be used as often as necessary and may be swallowed. Chew sugarless hard candies or gum to relieve dryness and refresh your mouth. Sour candies can increase the production of saliva. Use K-Y jelly or lanolin to moisten your lips. Avoid petroleum-based products such as Vaseline. Using petroleum based lubricants over a long period of time can cause dryness. Humidify the air at home with a cool mist vaporizer. A pan of water near the source of heat, or a humidifier as part of the central heating system can be used. Do not use tobacco products or drink alcohol. Filter smoke from rooms with a small, portable filtering device. It is possible that mouth rinses may be prescribed to control pain. Avoid lemon glycerin swabs. They may cause dryness.

5 3. To cope with taste changes: Preparing foods that smell good to you may stimulate your sense of taste. Experiment with spices and flavorings, such as basil, mint, lemon or vanilla, to enhance your sense of taste. Avoid adding large amounts of spices or flavorings that may irritate your mouth. It is very important to drink water and other fluids frequently. Avoid drinking acidic liquids such as orange, cranberry and grapefruit juice. These may burn damaged tissues. Eat sugar free mints or chew sugar free gum to mask a metallic or bitter taste sensation. Do not use foods that cause an unpleasant taste. Foods that cause an unpleasant taste sensation are high protein (beef, pork). Substitute other high protein foods such as cheese, eggs, milk and milk products, chicken and fish. Avoid the sight and smell of foods that cause an unpleasant reaction. Arranging for Dental or Mouth Care Always tell your cancer doctor if you need dental work. Tell your dentist you have cancer. Arrange for a dental exam and necessary dental treatment before you start the radiation therapy. Have your dentist call your cancer doctor before dental treatment is performed. If you have already begun radiation therapy before you have seen your dentist, be sure to have your dentist call your cancer doctor for information about your treatment. If you are in need of a dentist or have other questions you may contact: Advanced General Dentistry Clinic The Ohio State University College of Dentistry Postle Hall, 2nd Floor 305 West 12th Avenue Columbus, Ohio Telephone: (614)