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Head and Neck Radiation Treatment 

Radiation treatment to the head and neck may be associated with oral and dental side effects since radiation therapy to the head and neck not only affects cancer cells but also affects other cells in the mouth.

 

What type of side effects are associated with head and neck radiation therapy?

  • Mouth sores (mucositis)

  • Altered taste

  • Dry mouth and altered salivary flow

  • Oral infections

  • Painful gums and painful mouth

  • Jaw stiffness and trismus (reduced mouth opening)

  • Delayed wound healing (osteoradionecrosis of the jaw)

 
Why visiting an oral/dental oncologist before receiving radiation treatment to the head and neck is important:

A dental oncologist is a vital member of the oncology team as cancer therapy is multidisciplinary. Visiting a dental oncologist prior to undergoing head and neck radiotherapy may help reduce your risk of developing the head, neck and oral side effects associated with head and neck radiation therapy. Although some oral conditions may be unavoidable, visiting a dental oncologist is a crucial step in teaching you how to manage these effects and reduce their severity.

 

Untreated oral conditions could result in your oncology team halting your cancer therapy until your oral conditions are treated. It is important to note that, although it is ideal to visit a dental oncologist before undergoing radiation therapy, it is never too late to visit Dr. Levi.

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Why visiting an oral/dental oncologist after receiving radiation treatment to the head and neck is important:

After head and neck radiation therapy, you may notice some changes in your mouth, jaw, and surrounding structures. Visiting Dr. Levi after radiation therapy to the head and neck will help you manage these changes and show you how to prevent developing any long-term side effects of head and neck radiation therapy. There are several treatment modalities that can significantly help you manage the effects of head and neck radiation therapy, and Dr. Levi has extensive experience treating these conditions.  

 

What will Dr. Levi do at the first visit?

Dr. Levi will perform a comprehensive evaluation of your head, neck, jaw, and oral cavity. She will review with you any necessary procedures that may need to be performed prior to undergoing radiation therapy. If necessary, she will fabricate radiation mouthguards for you to wear during your radiation therapy. She will speak with your oncologist about your cancer therapy schedule and treatment plan as well as the ideal deal time to perform any necessary treatment. If you are currently undergoing radiation therapy, Dr. Levi will work with your oncology team to treat the head, neck, and oral side effects that you may be experiencing during therapy and how to manage them. Additionally, she will show you how to prevent developing radiation-related head, neck, and oral side effects and how to manage these side effects including how to prevent and treat jaw stiffness and reduced jaw opening.

Radiation Fibrosis and Trismus 

Radiation Fibrosis and Trismus

Radiation to the head and neck not only affects cancer cells but also neighboring healthy cells including the muscles of the head and neck. Unfortunately, radiation therapy to these structures sometimes may result in the tissues becoming fibrotic leading to jaw stiffness, muscle tightness, jaw pain, and trismus.

 

What is trismus?

Trismus is the medical term for a reduced or limited ability to open the jaws and is believed to be due to a spasm or tonic contraction of muscles. In addition to difficulty eating, trismus may result in an impaired ability to maintain oral hygiene. 

 

When do radiation fibrosis and trismus usually occur?

Radiation fibrosis may occur as early as a few weeks into treatment to several months after therapy. 

 

What are the symptoms of radiation fibrosis syndrome?

  • trismus (reduction in jaw opening)

  • numbness, tingling and neuropathy

  • orofacial pain

  • cervical dystonia (neck pain and spasms)

  • shoulder pain

  • facial lymphedema

 

Who is at risk for developing radiation fibrosis?

Not everyone who receives head and neck radiation therapy will develop radiation fibrosis. There are several factors that may contribute to one's risk for developing radiation fibrosis syndrome, including but not limited to, the radiation dosage and frequency, the site of the radiation therapy, and type of radiation therapy that was delivered. 

 

How is radiation fibrosis and trismus treated?

The best treatment is early intervention. Visiting a dental oncologist before undergoing radiation therapy or while undergoing therapy is helpful to evaluate your risk for developing radiation fibrosis syndrome and to review methods to help prevent it. Treatment and prevention are often multisciplinary and may include:

  • jaw exercises and physical therapy

  • occupational therapy

  • speech therapy

  • lymphedema therapy

  • jaw stretching devices

  • medications 

  • massage

  • acupuncture

  • botox injections

  • trigger point injections for muscle pain and tensions

  • behavior modification techniques

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