Dentures After Radiation Treatment: What’s Possible and Effective

By David Hudnall, DMD

The very mention of cancer is a scary thing. It often invokes a lot of soul-searching as cancer patients face their own potential mortality. With important life decisions at stake, it is no surprise that dental care often falls by the wayside. However, many changes occur during radiation therapy that profoundly affect the mouth.

The fact is your experience and comfort can be made better with the help of a caring dental professional who can help you navigate what you are about to face.

Radiation Treatment Effect on the Body

Radiation therapy is a type of cancer treatment that uses high doses of high-energy X-rays and gamma rays to kill or slow the growth of cancer cells by damaging their DNA. Cancer cells whose DNA is damaged beyond repair will stop dividing or die. When damaged cells die, they are broken down and removed by the body’s immune response.

Radiation not only kills or slows the growth of cancer cells; it also affects nearby healthy cells. Oncology patients requiring radiotherapy will experience damage to healthy cells that can cause collateral damage and unintended side effects. For example, head and neck cancer patients, especially oral cancer patients, often experience

• fatigue,
• hair loss,
• slowed salivary flow or loss of salivary function,
• taste alterations,
• irritated or swollen skin and mouth tissue,
• difficulty swallowing,
• jaw stiffness,
• and reduced thyroid function.

Healthy cells that are damaged during radiation treatment usually recover within a few months after treatment is completed. But sometimes, people may have lingering side effects that do not improve. Late side effects may also present themselves months or even years after radiation therapy is completed. This is why healthcare providers ask if you’ve ever undergone cancer treatment before treating you for other health problems.

Dental Treatment After Radiation Therapy

Before beginning any radiation therapy, talk to your cancer care team about having a complete oral health check-up. If you have one or more teeth that are bad, your dentist may suggest oral surgery to remove them before you begin treatment. Having a dry mouth after radiation will make your teeth more susceptible to advanced decay to the point that they must be removed. Additionally, radiotherapy-induced oral morbidities are not uncommon, especially after intensity-modulated radiation therapy.

Because complete dentures rest on the underlying jaw bone and the palate, they do not have any teeth present for support or retention. Their primary mode of staying in place is through suction created by intimate contact with the underlying tissue. For suction to occur, a thin layer of saliva must be present. In people who are undergoing radiation treatment, this does not happen. This is the reason why, after radiation treatment, dentures that used to fit well suddenly seem to be loose.

If you currently wear dentures, they also may no longer fit correctly because of swollen gum tissue after cancer treatment. If your dentures cause sores while receiving therapy, you may need to stop wearing them entirely until radiation treatment is over to minimize the chances for secondary infections. Your dentist may want to see you during your radiation therapy to check your teeth and dentures, talk to you about caring for your mouth, and help you address any dental problems that you may be experiencing.

Necessary Precautions

During and after the radiation therapy to the head or neck, it is essential to take good care of your teeth or dentures, gums, mouth surfaces, and throat. Mucositis, an extremely common problem caused by inflammation of the soft tissues inside of the mouth, occurs in the vast majority of cancer patients. It is a painful condition that can make it difficult to bear minor friction, mild spices, or temperature extremes. Here are some tips that will help address the symptoms of mucositis:

• Avoid spicy, heavily salted, or rough foods, such as dry crackers, chips, or nuts.
• Allow very hot or very cold foods and beverages to come to room temperature before consuming.
• Don’t smoke, chew tobacco, or drink alcohol – these can cause mouth sores to be more painful.
• To minimize tooth decay, stay away from sugary snacks and soft drinks.
• Use an alcohol-free mouthwash. The alcohol content in many mouthwashes has a drying effect that can irritate sensitive mouth tissues.
• Sip cool water or use saliva substitutes often throughout the day.
• Suck on sugar-free candy or chew gum to stimulate and improve salivary flow.
• Soften foods with gravies or sauces to make them easier to eat.
• Ask your dentist or cancer team about topical medications to treat mouth sores and control mouth pain.

Risks of Treatment Post-Radiation

Aside from emergency care, invasive or elective oral and maxillofacial surgery should be avoided or postponed until the radiation has been completed and you have had at least two months of recovery time. One of the biggest side effects of radiation is the loss of normal saliva production. Radiation caries will make your teeth susceptible to advanced tooth decay to the point that they can become abscessed and must be removed. This can prove to be risky at the beginning or shortly after receiving radiation treatment due to immune system suppression and the delayed healing response associated with therapy.

Likewise, having new dentures fabricated during or soon after radiation treatment is not advised since the tissue manipulation that takes place during the denture-making process can worsen mouth soreness and irritation. It is normal for healthy patients to experience gum sores after getting new dentures. The last thing you want to do after receiving high doses of radiation is to undergo dental work that is likely to make your mouth more sore or slow to heal.

Dental Treatment Options

If you are wearing dentures after radiation treatment and they make your mouth sore, see your dental professional right away. This is not the time for home remedies. The longer that you put off getting help, the longer it will take for your mouth to fully recover. A dentist or denturist may be able to improve your comfort with a simple denture adjustment or a soft reline to cushion dentures and prevent the dentures from rubbing against the gums and soft tissue.

Dentists can also help you address fungal overgrowth caused by oral candidiasis that commonly occurs in patients who have received cancer treatment. The proliferation of fungus and bacteria overgrowth can present as a white film that can exacerbate tissue sensitivity. Candidiasis is easily treated with prescription mouth rinses and oral medications.

See Also: Why Your Dentures Cut Into Gums & Cause Pain

Importance of Regular Dental Appointments

Even though you may not feel like it, and your dental health may not seem important with everything else that you are experiencing, a critical part of your recovery involves receiving preventative dental care.

Tooth problems or sores caused by wearing dentures after radiation treatment can quickly get out of hand and lead to secondary infections that are more difficult to heal for medically compromised patients.

Superior Services at European Denture Center

European Denture Center understands that keeping patients comfortable in their dentures after radiation treatment is key to improved recovery. We offer services that are critical, including soft relines and removable partial denture adjustments, to help patients wear their dentures. When your health improves, and it’s time for new dentures, our Advanced Comfort dentures are just the prescription for success.

If you are about to undergo cancer treatment, don’t forget about your dental health. Schedule your cancer pre-treatment exam today!