Dental Health After Pediatric Cancer Therapy
What’s the risk?
Dental health is the health of your teeth and the roots of your permanent teeth. It is thought that both chemotherapy and radiation may affect dental health over time.
Specifically, we know radiation can cause loss of saliva (dry mouth) if the area radiated includes the glands that produce saliva. Saliva plays a very important role in preventing cavities and tooth decay, and in speech and swallowing. Loss of saliva can result in cavities and more rapid tooth decay.
Children and adolescents who received radiation or chemotherapy prior to the development of permanent teeth are at risk for a failure of teeth to develop or root and enamel abnormalities.
Rarely, patients who received radiation to the jaw are at risk for osteoradionecrosis of the jawbone. This complication is an inability of bone to heal after minor trauma. It may occur after a dental procedure (such as pulling a tooth). Symptoms of osteoradionecrosis include jaw pain or an inability to open the jaw. Be sure your dentist knows if you received radiation to the jaw.
Symptoms/ When to Call
- Mouth pain, a tooth falling out, or other dental concerns should be brought up to a dentist or oral surgeon.
- Survivors should let their dentist know about their cancer history and treatment.
Prevention and Treatment
- Dental visits, including cleanings every 6 months, oral exams annually, and a baseline panoramic x-ray are important to detect problems early.
- If you received radiation to the mouth area, you will be given further instructions on mouth care.
- For survivors who received high doses of radiation in the mouth area (such as for treatment of cancers in the head and neck), hyperbaric oxygen treatment may be recommended before or after dental procedures. Hyperbaric oxygen can help improve wound healing.