Overview

Radiotherapy and chemotherapy can cause side effects, such as a dry, sore mouth, and make you more likely to have dental disease. To avoid oral complications during and after your cancer treatment, it is important that your teeth and gums are as healthy as possible.

Before cancer treatment

We will explain how your cancer treatment might affect your future dental care. We might prescribe you a sodium fluoride toothpaste (Duraphat^® 5000) to help protect your teeth.

If your teeth and gums are not healthy, you might have problems with pain and infection during or after your cancer treatment. Sometimes these problems can be severe.

Dental assessment appointment

A specialist dentist will discuss the current health of your teeth and gums with you. Any teeth which are likely to cause you pain or infection in the future might be recommended for extraction (removal).

Any dental extractions needed are usually done before you start your cancer treatment, or within the first year after treatment.

Deciding which teeth to recommend for extraction

It is not always easy to decide which teeth should be removed. Often more than 1 dentist will be involved in making the decision, and many things are considered. These include the location of your cancer, and what type of treatment you will have. If your teeth are decayed, filled or loose, this will also affect the decision.

Sometimes, even healthy teeth (particularly back teeth) might be recommended for extraction. This is because the side effects of radiotherapy might complicate your future dental care. The dentist will always discuss with you why an extraction is being recommended.

Dental extraction

Most dental extractions are done under a local anaesthetic. This means the dentist gives injections into your gums to numb your mouth and prevent pain during the procedure.

Having the local anaesthetic injections can be uncomfortable, but after this the procedure should not be painful.

After your extractions you can go home. Your dentist will give you instructions about how to look after your mouth while the gums heal, and what painkillers to take.

Can extracted teeth be replaced?

Unfortunately, teeth extracted in preparation for cancer treatment cannot usually be replaced after treatment is completed. It is best to ask for advice about your individual situation when you see your dentist. Some methods of replacing teeth might increase your risk of developing osteoradionecrosis (ORN). ORN is when some of the tissues in your jaw die.

Feeling anxious about dental work

It is common to feel anxious about dental extractions. If you think that your anxiety is too great, let the dentist know. Sometimes we can arrange sedation or a general anaesthetic for your treatment. However, having a local anaesthetic is generally the best way to avoid any delay to the rest of your cancer treatment.

Giving your permission (consent)

We want to involve you in decisions about your care and treatment. If you decide to have the procedure or treatment, we will ask you to sign a consent form. This says that you understand what is involved and agree to have the treatment.

Read more about our consent process.

During and after cancer treatment

Some of the side effects, such as soreness, dry mouth and loss of taste, might gradually get better in the weeks and months after treatment. Unfortunately, some people will have a permanently dry mouth.

Cancer treatments cause permanent changes to the mouth, teeth and jaws. Because of this you will always be at a higher risk of developing dental problems than before. This is why it is extremely important to go for regular check-ups with a dentist. You should go to get checked even if you are not aware of any problems.

Read our information about mouth care during and after cancer treatment.

Future dental treatment

After cancer treatment, most patients are discharged from the hospital back to the care of their own dentist. It is essential that you are registered with a dentist.

Follow-up appointments

We will tell you if you need a follow-up appointment with the hospital's dental service.

Support and more information

Cancer Research UK are a charity that gives information on all types of cancer and treatment options.
www.cancerresearch.org

Macmillan Cancer Support are a charity that gives information and support to anyone affected by cancer.
www.macmillan.org.uk

Dimbleby Cancer Care offer support and information during cancer treatment.
www.guysandstthomas.nhs.uk/our-services-dimbleby-cancer-care