Dry mouth can cause an increased risk for dental caries, periodontal disease, stomatitis, difficultly in swallowing and loss of taste. Symptoms can start after 1 week of radiation therapy and last up to 6 months or longer after treatment has ended. Dental caries are a long-term concern for patients who have undergone radiation therapy. Because of the painful mucosa, patients are less likely to brush or floss. Lack of good oral hygiene and saliva can attribute to an increase in radiation caries.
Patients initially seek medical help for persistent jaw pain or toothache.
Trismus is a chronic effect of head and neck radiation. It occurs as a result of scar formation on the muscles of mastication. These patients have a reduced capacity to open their mouth making it difficult placing food in their mouth and chewing the food. An initial dental and oral exam should occur immediately after diagnosing the cancer, or at least 2 weeks before beginning radiation therapy. A panoramic and full mouth series of radiographs will also be taken to detect the extent of periodontal disease or teeth that need extracted.