Radiation-Induced Mouth Sores

The mouth is among the complex parts of the body, with many types of cells and tissues. Below are some of the ways in which the mouth is unique:

●      It’s the only place where hard tissue, the teeth is exposed.

●      Specialized tissue, nerves, and muscles help us to eat, taste, swallow and speak.

●      Both the ball-and-socket and sliding movement joints are found here.

●      It has glands that produce saliva for lubrication.

There are some types of cancer treatment which interfere with its functions.

1. Surgery is a part of the treatment plan for some cancers of the head and neck. Sometimes, surgery affects the mouth and its associated structures, like the salivary glands. If you are having surgery, it’s good to discuss possible oral side effects with your oncologist.
2. Treatment such as chemotherapy, radiation therapy to the head or neck region almost always has side effects.

Some of the side effects that can affect the mouth are described below:

●      Mouth sore -  It is the most common side effect. Mouth sores ussually occur on the cheeks, tongue, floor of the mouth, & on the soft palate. Though it causes severe pain, most heal on their own.

●      Stiff jaw -  Radiation therapy may cause stiffnes of the jaws.

●      Dry mouth - Drugs and Radiation therapy to the head and neck region can affect the salivary glands. This may restrict the saliva production thereby making the mouth dry. This condition is called xerostomia.

●      Dental issues. When enough saliva is not produced, plaque can build up more easily on your teeth this can cause tooth decay and gum disease.

 

Mouth Sores or Mucositis

A person during the cancer treatment may have swelling inside the mouth and throat which can lead to painful mouth sores. This condition is called mucositis. This Radiation-induced oralmucositis (RIOM)  marks adverse effects on patient quality of life and cancer therapy continuity. It is a challenge for radiation oncologists since it leads to cancer therapy interruption, poor local tumour control, and changes in dose fractionation. 

  How are mouth sores treated?

Before you start cancer treatment

●      Visit your dentist at least four weeks before starting radiation therapy to the head or neck area. This to treat all the present dental issues. During the treatment these dental issues may aggravate which may lead to even possibly interrupting treatment.

During and after the treatment

●      The best way to manage mouth sores is to prevent them or treat them early. During chemotherapy, sucking on ice chips before and during treatment may prevent mouth sores. Visit a dentist that specializes in cancer care

●      The doctor may other recommend pain relief strategies like a mouthwash solution. Ingredients in mouthwash may vary, but it typically includes an antihistamine, anaesthetic, an antacid, antibiotics, and/or an antifungal.

●      You may be prescribed over the counter pain relief medicine. Avoid taking aspirin during cancer treatment unless your doctor tells you otherwise.

●      Although mouth sores may make it uncomfortable it is important to continue to eat and drink regularly during cancer treatment. Talk to registered whether you need to take food supplements, such as protein shakes, to get the required nutrition.

It is very important to take special care of your mouth during cancer treatment. The following oral hygiene tips should be followed:

●      Brush your teeth gently several times a day. If the mouth sores are severe, use an oral sponge, instead of a toothbrush

●      Floss gently

●      Rinse or gargle with a solution of saltwater and baking soda

●      Avoid mouth rinses which contain alcohol

●      If you wear dentures, lessen the time that you wear them. Avoid wearing them at night and consider removing them between meals

●      Choose foods that require little or no chewing

●      Avoid acidic, spicy, salty, coarse, and dry foods

●      Drink through a straw to help avoid irritating your mouth sores

●      Other strategies undergoing further study using clinical trials include the use of cryotherapy or low-level laser therapy

At times, oral hygiene may seem like a low priority, but it’s worth the investment. These practices will greatly reduce your risk of infection and help you have a healthy mouth after treatment ends.

Conclusion

In most cases,  RIOM may lead to a reduction of dosages in the treatment of head and neck cancer patients. However, in moderately to severely sick patients, it could be a lethal injury. Many clinical studies have been conducted for the prevention and treatment of RIOM.

Though, there are numerous prevention and treatment strategies for RIOM, no single has been agreed upon by the researchers, that significantly improves RIOM to a clinically relevant and satisfactory standard.

As of now, almost all guidelines recommend good oral care, IMRT, radiation shields, palifermin, amifostine, and cryotherapy for RIOM prevention. RIOM treatment presently focuses on palliative measures and symptoms relief; e.g., pain management, nutritional support, good oral hygiene, and reduced oral microbial load.