Head 

 and

Neck 

Radiation 

Treatment

 and Your

 Mouth

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

National Institutes of Health
This booklet is part of the series, 

Oral Health, Cancer Care, and You: 

Fitting the Pieces Together, focused on 

managing and preventing oral complications 

of cancer treatment. The series was 

developed by the National Institute of 

Dental and Craniofacial Research in 

partnership with the National Cancer 

Institute, the National Institute of Nursing 

Research, and the Centers for Disease 

Control and Prevention.

For more information about oral 

complications of cancer treatment or 

to order free publications, contact:

National Institute of Dental and 

 Craniofacial Research

National Oral Health Information Clearinghouse

1 NOHIC Way

Bethesda, MD 20892–3500

1–866–232–4528

http://www.nidcr.nih.gov
1

Are You Being Treated 

With Radiation for 

Cancer in Your Head 

or Neck? 

If so, this booklet can help you. While head 

and neck radiation helps treat cancer, it can 

also cause other things to happen in your 

mouth called side effects. Some of these 

problems could cause you to delay or 

stop treatment.

This booklet will tell you ways to help 

prevent mouth problems so you’ll get the 

most from your cancer treatment.

To help prevent serious problems, 

see a dentist ideally 1 month before 

starting radiation.

A dentist can help prevent mouth problems.
2

How Does Head and 

Neck Radiation Affect 

the Mouth?

Doctors use head and neck radiation 

to treat cancer because it kills cancer 

cells. But radiation to the head and neck 

can harm normal cells, including cells in 

the mouth. Side effects include problems 

with your teeth and gums; the soft, moist 

lining of your mouth; glands that make 

saliva (spit); and jaw bones.

It’s important to know that side 

effects in the mouth can be serious. 

•	The side effects can hurt and make it 

hard to eat, talk, and swallow. 

•	You are more likely to get an infection, 

which can be dangerous when you are 

receiving cancer treatment.

•	If the side effects are bad, you may not 

be able to keep up with your cancer 

treatment. Your doctor may need to cut 

back on your cancer treatment or may 

even stop it.
3

What Mouth Problems 

Does Head and Neck 

Radiation Cause?

You may have certain side effects in your 

mouth from head and neck radiation. 

Another person may have different 

problems. Some problems go away 

after treatment. Others last a long 

time, while some may never go away.

•	Dry mouth. 

•	A lot of cavities. 

•	Loss of taste. 

•	Sore mouth and gums.

•	Infections. 

•	Jaw stiffness. 

•	Jaw bone changes. 

You can see or feel most of these problems. 

Check your mouth every day.
4

Why Should I See 

a Dentist?

You may be surprised that your dentist 

is important in your cancer treatment. 

If you go to the dentist before head and 

neck radiation begins, you can help prevent 

serious mouth problems. Side effects often 

happen because a person’s mouth is not 

healthy before radiation starts. Not all 

mouth problems can be avoided but the 

fewer side effects you have, the more 

likely you will stay on your cancer 

treatment schedule. 

It’s important for your dentist and 

cancer doctor to talk to each other 

before your radiation treatment 

begins. Be sure to give your dentist 

your cancer doctor’s phone number. 

When Should I See a Dentist?

You need to see the dentist 1 month, 

if possible, before your first radiation 

treatment. If you have already started 

radiation and didn’t go to a dentist, see 

one as soon as possible.
5

What Will the 

Dentist and Dental 

Hygienist Do?

•	Check and clean your teeth.

•	Take x-rays.

•	Take care of mouth problems.

•	 Show you how to take care of your 

mouth to prevent side effects.

•	 Show you how to prevent and treat jaw 

stiffness by exercising the jaw muscles 

three times a day. Open and close the 

mouth as far as possible (without 

causing pain) 20 times.

The dentist will do a complete exam.
6

What Can I Do To Keep

My Mouth Healthy?

You can do a lot to keep your mouth 

healthy during head and neck radiation. 

The first step is to see a dentist before 

you start cancer treatment. Once your 

treatment starts, it’s important to look in 

your mouth every day for sores or other 

changes. These tips can help prevent and 

treat a sore mouth:

Keep your mouth moist.

•	Drink a lot of water.

•	 Suck ice chips.

•	Use sugarless gum 

or sugar-free 

hard candy.

•	Use a saliva 

substitute to help 

moisten your 

mouth. 
7

Clean your mouth, tongue, and gums.

•	Brush your teeth, gums, and tongue with an 

extra-soft toothbrush after every meal and 

at bedtime. If it hurts, soften the bristles in 

warm water.

•	Use a fluoride toothpaste.

•	Use the special fluoride gel 

that your dentist prescribes.

•	Don’t use mouthwashes 

with alcohol in them.

•	 Floss your teeth gently 

every day. If your 

gums bleed and hurt, 

avoid the areas 

that are bleeding 

or sore, but 

keep flossing your other teeth.

•	Rinse your mouth several times a day with 

a solution of 1⁄4 teaspoon each of baking 

soda and salt in one quart of warm water. 

Follow with a plain water rinse.

•	Dentures that don’t fit well can cause 

problems. Talk to your cancer doctor 

or dentist about your dentures.
8

If Your Mouth Is Sore, Watch 

What You Eat and Drink.

•	Choose foods that are good for you 

and easy to chew and swallow. 

•	Take small bites of food, chew slowly, 

and sip liquids with your meals.

•	Eat moist, soft foods such as cooked 

cereals, mashed potatoes, and 

scrambled eggs.

•	If you have trouble swallowing, soften 

your food with gravy, sauces, broth, 

yogurt, or other liquids.

Sipping liquids with your meal will 

make eating easier.
9

Call Your Doctor or Nurse 

When Your Mouth Hurts.

•	Work with them to find medicines 

to help control the pain.

•	If the pain continues, talk to your cancer 

doctor about stronger medicines.

Remember To Stay Away From

•	 Sharp, crunchy foods, like taco chips, 

that could scrape or cut your mouth.

•	 Foods that are hot, spicy, 

or high in acid, like citrus 

fruits and juices, which 

can irritate your mouth.

•	 Sugary foods, like candy 

or soda, that could 

cause cavities.

•	Toothpicks, because 

they can cut 

your mouth.

•	All tobacco 

products.

•	Alcoholic drinks.
10

Do Children Get 

Mouth Problems Too?

Head and neck radiation causes other 

side effects in children, depending on 

the child’s age.

Problems with teeth are the most common. 

Permanent teeth may be slow to come in 

and may look different from normal teeth. 

Teeth may fall out. The dentist will check 

your child’s jaws for any growth problems.

Before radiation begins, take your child 

to a dentist. The dentist will check your 

child’s mouth carefully and pull loose teeth 

or those that may become loose during 

treatment. Ask the dentist or hygienist 

what you can do to help your child with 

mouth care.

Your child has special dental needs.
11

Remember:

•	Visit your dentist before your head 

and neck radiation treatment starts.

•	Take good care of your mouth 

during treatment.

•	Talk to your dentist about using 

fluoride gel to help prevent 

the cavities that head and neck 

radiation causes.

•	Talk regularly with your cancer doctor 

and dentist about any mouth problems 

you have during and after head and neck 

radiation treatment. 

Call your cancer doctor or dentist if 

you have any mouth problems.
Acknowledgments

The individuals listed here provided assistance in developing 

and reviewing all of the publications in this series. The National 

Institute of Dental and Craniofacial Research and its partners 

would like to thank them for their contributions.

Scientific Committee

Gerry Barker, RDH, MA

University of Missouri-Kansas City

Kansas City, MO 

Susan L. Beck, PhD, APRN, FAAN

University of Utah

Salt Lake City, UT

Marylin J. Dodd, PhD, RN, FAAN

University of California, San Francisco

San Francisco, CA

Joel Epstein, DMD, MSD, FRCD(C), FDSRCSE

University of Illinois at Chicago 

Chicago, IL

Philip Fox, DDS

Spello, Italy

Deborah B. McGuire, PhD, RN, FAAN

University of Maryland

Baltimore, MD

Douglas E. Peterson, DMD, PhD

University of Connecticut

Farmington, CT 

Mark M. Schubert, DDS, MSD

University of Washington

Seattle, WA

John R. Wingard, MD

University of Florida

Gainesville, FL

Publications in the Oral Health, Cancer Care, and You

series include:

For Patients

Chemotherapy and Your Mouth

La quimioterapia y la boca 

Head and Neck Radiation Treatment and Your Mouth 

La boca y el tratamiento de radiación en la cabeza y el cuello

Three Good Reasons to See a Dentist 

BEFORE Cancer Treatment

Tres buenas razones para ver a un dentista 

ANTES de comenzar el tratamiento contra el cáncer 

Three Good Reasons to See a Dentist 

BEFORE Cancer Treatment 

(illustrated booklet for adults with limited reading skills) 

For Health Professionals

Dental Provider’s Oncology Pocket Guide

Oral Complications of Cancer Treatment: 

What the Dental Team Can Do

Oncology Pocket Guide to Oral Health 

Oral Complications of Cancer Treatment: 

What the Oncology Team Can Do 

Order free publications online at http://www.nidcr.nih.gov 

or call toll-free 1–866–232–4528.
National Institute of Dental 

and Craniofacial Research

Centers for Disease 

Control and Prevention
National Institute of Dental

and Craniofacial Research

National Oral Health 

Information Clearinghouse

1 NOHIC Way

Bethesda, MD 20892–3500

1–866–232–4528

http://www.nidcr.nih.gov

This publication is not copyrighted. 

Make as many photocopies as you need.

NIH Publication No. 13–4362

April 2013

NIH...Turning Discovery Into Health®