4 Oral Complications of Radiation Therapy

If you are undergoing radiation therapy for a cancer of the head or neck, you are at risk of a wide variety of oral health complications. The radiation will not just target your cancer cells, it will also have an effect on your nearby healthy cells. Here are four oral complications that you may experience as a result of your treatment.


If the radiation damages your salivary glands, they will not be able to produce as much saliva. This leads to xerostomia, also called dry mouth. Xerostomia is a big problem because saliva does a lot of important things for your oral health. In addition to keeping your mouth moist, saliva also washes away food particles and acids and keeps the bacteria inside your mouth under control.

Xerostomia may be a long-term complication, though some people do start to see improvement in the year after their treatment concludes. The condition can be managed by keeping the mouth moist. Here are some ways to do that:

  • Sip water throughout the day
  • Suck on the sugar-free candies
  • Use artificial saliva as needed
  • Use dry mouth toothpaste or dry mouth mouthwash
  • See your dentist for prescription options, such as medications that stimulate saliva production

Radiation Caries

People who have undergone radiation therapy have an increased incidence of tooth decay compared to people who have not undergone this treatment. This increased level of tooth decay occurs due to xerostomia; if you do not have enough saliva, the bacteria that cause tooth decay are able to multiply unchecked.

This complication can start within weeks of finishing your treatment. The signs of radiation caries include toothaches, tooth discoloration, or tooth sensitivity. If you notice any changes in your teeth, make sure to point them out to your dentist. Radiation caries can be repaired with treatments that you are probably already familiar with such as fillings or crowns.


Periodontitis, a type of severe gum disease, can also occur as a result of radiation therapy. Periodontitis is an infection that develops in response to bacteria-filled plaque along your gum line, and while it can happen to anyone who doesn't brush or floss thoroughly, you're more likely to get it while undergoing radiation therapy. This is because radiation therapy causes changes inside your mouth that make you more susceptible to the infection. Radiation leads to inflammation, hypo vascularization, and thickening of your gum tissues, which makes it harder for your gums to heal themselves.

If you develop periodontitis, you will notice that your gums are red, sore, and bleeding. As the infection progresses, you will notice pus coming out of your gums, loose teeth, or even missing teeth. Your dentist can treat your infection with a deep cleaning of your gum tissue and a prescription for antibiotics.


People who are undergoing radiation therapy are also more likely to develop oral candidiasis than the general population. One study found that 55.2% of radiation patients had the infection, compared to only 11.8% of the control group.

Oral candidiasis is an opportunistic fungal infection caused by a fungi that is already present inside your mouth, candida. Xerostomia is the trigger for this infection; without saliva to control it, the candida that is already inside your mouth can multiply quickly and lead to infection.

If you have oral candidiasis, you will notice white lesions inside your mouth. These lesions have a lumpy, cottage cheese-like texture and will bleed if you rub or scrape them. Your dentist can treat the infection with a prescription antifungal medication.

If you notice any of these changes inside your mouth during or after your radiation treatment, make sure to make an appointment with services like Landy Michael G DDS.