Head and Neck Cancer: Radiation Therapy


What is radiation therapy?

Radiation therapy is a form of cancer treatment that uses high energy X-rays to kill cancer cells, while minimizing damage to healthy cells.

Procedure Details

What happens during radiation therapy treatment?

The radiation therapist will escort you into the treatment room. The therapist will help you onto the treatment table and help place you in the correct treatment position. Once the therapist is sure you are positioned correctly, he or she will leave the room and start the radiation treatment.

There are cameras and an intercom in the treatment room, so the therapist can always see and hear from you. If you have a problem, you can let the therapist know. It is very important that you remain still and relaxed during the treatment.

The therapist will be in and out of the room to move the treatment machine and change your position. The machine will not touch you and you will feel nothing during the treatment. Each treatment usually takes less than 10 minutes. Once your treatment is complete, the therapist will help you off the treatment table.

How will the radiation therapist know I am in the correct position?

The radiation therapist will take an X-ray, also known as a "port film," on the first day of treatment and about every week thereafter. Port films confirm that you are being positioned accurately during your treatments.

Risks / Benefits

What are the complications of radiation for head and neck cancer?

Here are some of the problems that can come up during radiation treatment for head and neck cancer, and afterward:

Xerostomia (dry mouth)

  • One of the main side effects is that you will produce less saliva, or spit. Your saliva will also become thicker and stickier, depending on how much radiation was delivered to your salivary glands. Your risk of dry mouth will depend on where your cancer is located. Your radiation oncologist will talk to you about this.
  • If you have less saliva after radiation therapy, make sure you get enough fluids. It may be helpful to sip water throughout the day. There are also several over-the-counter products that can help ease the dryness. Your saliva may continue to improve for months after you complete radiation treatment.

Radiation caries (tooth decay)

  • Radiation caries, or tooth decay, is caused by dry mouth after the radiation treatment. Radiation caries occur because you are producing less saliva, which means there is less saliva available to neutralize the bacteria that cause tooth decay and cavities. There is also less saliva to strengthen tooth enamel.
  • Radiation caries is caused by damage to the salivary glands during radiation, not by damage to the tooth itself. This means that you can have radiation caries if your salivary glands have received radiation, even if your teeth did not.

Osteoradionecrosis (bone death)

  • One of the most severe side effects of radiation therapy is osteoradionecrosis or bone death. Radiation can destroy some of the small blood vessels that carry oxygen and nutrients within the bone. This keeps the bone from being able to heal. The bone may become infected and painful. In some cases, the patient can even lose part of the jaw. While this side effect is rare, it can be quite serious.
  • To reduce the risk of osteoradionecrosis, be careful before having any invasive dental procedures after radiation. If you are thinking about having dental surgery, let your dentist know that you have received radiation treatments.
  • If you have to have a tooth pulled after you have had radiation, hyperbaric oxygen therapy may lower the risk of osteoradionecrosis. Hyperbaric oxygen therapy floods the bone with oxygen in a pressure chamber.

Your dentist may contact your radiation oncologist to learn how much radiation you received in the jaw. This will help the dentist weigh the risks of a particular dental procedure and determine if preventive measures are needed.

If you wear an appliance, such as dentures, see your dentist for adjustments on a regular basis. This will help prevent tissue irritation that may lead to tissue death.

Other problems

Some of the other problems that can develop after you have had radiation for head and neck cancer include:

  • Infection
  • Changes in the way food tastes
  • Trouble opening your mouth
  • Swelling and ulcers in your gums
  • Problems with tooth development (in younger patients)

Additional Details

How can I prevent complications from radiation for head and neck cancer?

Because you are at greater risk for tooth decay after radiation treatment for head and neck cancer, you will need to practice preventive dental care. Here are some of the steps you should take:

  • Brush your teeth at least two times a day with a soft toothbrush.
  • Floss your teeth at least once a day.
  • See your dentist on a regular basis.
  • Have your teeth cleaned by a hygienist every three months. This will help keep your teeth clean, and will find cavities or other problems early.
  • Have a fluoride treatment every day. You will receive fluoride trays that are custom-made to fit your teeth. You will be given instructions on how to use the tray. It takes only five minutes.

If your mouth gets dry, try these steps:

  • Sip water throughout the day.
  • Suck ice chips or sugar-free candy.
  • Chew sugar-free gum.
  • Use a saliva substitute spray or gel, or a saliva stimulant if your doctor prescribes one.

Last reviewed by a Cleveland Clinic medical professional on 04/26/2016.


  • The Oral Cancer Foundation. Radiation (http://oralcancerfoundation.org/treatment/radiation/) Accessed 4/26/2016.
  • American Cancer Society. Radiation therapy for head and neck cavity and oropharyngeal cancer (http://www.cancer.org/cancer/oralcavityandoropharyngealcancer/detailedguide/oral-cavity-and-oropharyngeal-cancer-treating-radiation-therapy) Accessed 4/26/2016.
  • National Cancer Institute. Lip and Oral Cavity Cancer Treatment (https://www.cancer.gov/types/head-and-neck/patient/adult/lip-mouth-treatment-pdq) Accessed 4/26/2016.

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