Dry mouth (xerostomia), is most commonly caused by radiation therapy directed at the head and neck region of the body. Radiation may irreversibly affect the production and quality of saliva in the salivary glands. A number of medications can also induce xerostomia. Dry mouth may affect the patients speech, taste sensation and ability to swallow.
Many patients complain of a sore or burning sensation, cracked lips, and fissures in the corners of the mouth. There is also an increased risk of cavities and mouth disease due to less saliva to cleanse the teeth and gums.
There are now some means of preventing xerostomia that were not available a few years ago. Amifostine, a radiation protector of normal tissues, has been shown to protect the salivary glands when given daily with radiation therapy. Also, a treatment known as Proton therapy may allow the radiation oncologist to spare the salivary glands from getting significant radiation doses. This may prevent dry mouth in the future. If you are getting radiation therapy to the head and neck region, you should discuss these options with your radiation oncologist. If you have developed xerostomia, there are management strategies that can effectively deal with your dry mouth and prevent cavities and periodontal disease.
Try to follow these simple guidelines:
- Perform oral hygiene at least four times a day. (After each meal and before bedtime)
- The oral cavity should be rinsed and wiped immediately after meals
- Dentures need to be brushed and rinsed after meals
- Only use toothpaste with fluoride when brushing
- Keep water handy to keep the mouth moist at all times
- Apply prescription strength fluoride gel at bedtime
- Rinse with salt and baking soda solution 4-6 times a day
- Avoid liquids and foods with high sugar content
- Avoid rinses containing alcohol
- Use moisturizer regularly on lips
- Oral pilocarpine (Salagen) is the only drug approved by the FDA to stimulate saliva secretion from the remaining salivary glands.
1. Thanks very much for this post.
Radiation-induced xerostomia has, years out from my total thyroidectomy, been the overall worst thing about my cancer (aside from financial and insurance issues and all that other stuff). Lowered saliva flow can cause the surface of your teeth to rapidly demineralize with potentially catastrophic results. It wasn't until I could barely speak and my teeth were falling out like an ivory hailstorm, that dentists and doctors put two and two together and informed me that my glands had been nuked into submission. It had never occured to me, and why would it have, what a precious thing saliva is. It truly was an awful, as well as cripplingly expensive, experience for several years. And get this--I went to three oral specialists who simply shrugged and told me there was nothing that could be done and to simply get used to it... until one spent about 30 seconds with me and then wrote a prescription for pilocarpine. (it's available as a generic now.) That night I think I cried for the first time in my whole cancer experience--and it was from joy--when I woke up to find a slight trickle of saliva on my cheek.
A dentist soon thereafter recommended that I soak my teeth with Gel-Kam (an over the counter flouride gel) every day to keep my dry mouth from causing my teeth to rapidly demineralize and rot away, and soon the relentless decay subsided.
Back when I had my surgery, there were virtually no resources for finding info (like this site!) and my doctors failed to tell me anything about the possible side effects. Apparently there is some debate about doing simple things like sucking lemon drops during the radioactive period to stimulate flow and possibly protect the glands. Worth asking about, and better safe than sorry, regardless of what opinions you hear. If there are new scientific safeguards and your insurance will not cover them, consider paying out of pocket yourself. It's an investment that will definitely pay off.
I'm going on and on about this but it has obviously triggered some harrowing memories. You may not notice that radiation has slowed your saliva, but if you have had it you should really become extra vigilant in your dental care.
If nothing else, it will make it easier to paste on that all-important society-approved "just stay positive" smile.
Smiles and best regards to all,
Richard Day Gore
Posted at 4:03PM on Feb 16th 2007 by richard day gore