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Dry Mouth After Radiation Therapy: Managing Radiation-Induced Xerostomia
Xerostomia, or oral dryness, is one of the most common complaints experienced by patients who have had radiotherapy of the oral cavity and neck region.
What Is Radiation-Induced Xerostomia?
Radiation-induced xerostomia is chronic dry mouth caused by damage to the salivary glands during radiation therapy, especially for head and neck cancers. Symptoms can include difficulty swallowing, tooth decay, gum disease, mouth infections, and impaired speech. Treatments may include saliva substitutes, acupuncture, xylitol gum, hydration strategies, and integrative therapies.
I underwent local radiation to my newly resected fifth cervical vertebra in February of 1994. I was told I had a single bone plasmacytoma (Multiple Myeloma) in my C5 that had to be removed. I underwent local radiation to the area following the surgical procedure.
During the years following the local radiation therapy, I developed a long-term side effect called xerostomia. In effect, my local radiation damaged my salivary glands’ ability to produce saliva. I learned the hard way just how useful and important saliva is to us.
Xerostomia or dry mouth, if left unchecked, can lead to a host of dental and overall health problems. Because saliva cleans the mouth and remineralizes teeth, lack of sufficient saliva encourages cavity development and acid erosion. Gum disease and tooth loss are common results of xerostomia, as well.
How Radiation Therapy Causes Dry Mouth
Radiation therapy causes dry mouth (xerostomia) by directly damaging the salivary glands, reducing their ability to produce saliva, or making it thick and sticky. High doses of radiation, common in head and neck cancer treatment, can cause this damage to be permanent
Symptoms of Radiation-Induced Xerostomia
Radiation-induced xerostomia (dry mouth) results in a significant reduction in saliva, leading to chronic oral dryness, thick or ropey saliva, and profound difficulties with eating, chewing, and speaking. It often causes pain, taste changes, increased dental decay, and sleeplessness, often becoming a permanent, quality-of-life-altering condition for head and neck cancer survivors. [1, 2, 3, 4]
Long-Term Risks of Chronic Dry Mouth
Chronic dry mouth (xerostomia) significantly increases long-term risks of severe oral health issues, including rapid tooth decay, gum disease, and tooth loss. Without adequate saliva to neutralize acids and wash away bacteria, patients often face chronic infections like thrush, difficulty chewing/swallowing, and impaired nutrition. [1, 2, 3, 4, 5, 6]
My Experience With Radiation Fibrosis and Xerostomia
My initial xerostomia experience was a filling that fell out back in 2001, 6 years after local radiation therapy to my C5. That led to an emergency visit to the dentist and several years of trying to figure out possible therapies to heal my dry mouth. Long story short, while I have not completely healed my xerostomia, I have learned to control the symptoms.
Evidence-Based Therapies to heal radiation fibrosis that causes xerostomia?
have been shown to reduce the damage done by radiation (resveratrol and melatonin) and heal radiation damage. I do neck sit-ups (shaker exercise) every morning for my dysphagia. (Dysphagia is closely related to xerostomia in my case)
I get bored if I just hold my head off the floor. So I do sit-ups, front, side, on my stomach, yada yada…
I do all three therapies regularly and have for years now. The only addendum I would add is to begin this therapy ASAP following local radiation to your head and neck area. I would also consider hyperbaric oxygen therapy immediately following radiation therapy.
In short, this post and links to my blog posts documenting this side effect is designed to address my mantra of “I wish I knew then what I know now-“
- To Learn More about radiation dermatitis- click now
- Learn about healing chemotherapy-induced aging- click now
- To Learn More about xerostomia- click now
- Learn about my long-term myeloma survivor experience- click now
- To Learn More About the pros and cons of Ionising Radiation- click now
- To Learn More about short, long-term and late stage side effects- click now
Can Xerostomia Improve Over Time?
Yes. Xerostomia can heal over time. The sooner you identify this side effect and begin therapies to heal it, the better off you’ll be.
Scroll down the page, post a question or a comment and I will reply to you ASAP.
Thanks and hang in there-
David Emerson
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
Recommended Reading:
- Multiple Myeloma Side Effects- Radiation-Induced Lumbosacral Plexopathy
- Long-Term Multiple Myeloma Survivor- If I Knew Then What I Know Now
- Cancer Coaching Testimonials- PeopleBeatingCancer
Questions to Ask Your Oncologist or Dentist
- Can radiation-induced xerostomia be reversed?
- What helps dry mouth after radiation therapy?
- Does acupuncture help xerostomia?
- Why does radiation damage salivary glands?
- Can xerostomia cause tooth loss?
- Is xerostomia permanent?
To learn more:
Side Effects Cluster
- chemotherapy-induced cardiotoxicity
- chemotherapy-induced skin damage
- chemotherapy-induced peripheral neuropathy
- radiation-induced dysphagia
- chemotherapy-induced mucositis/stomatitis
- radiation dermatitis
Integrative Therapy Cluster
- acupuncture and cancer
- melatonin and cancer
- hyperbaric oxygen therapy
- nutritional supplements and cancer
Survivor Cluster
Radiation-induced xerostomia: pathophysiology, clinical course and supportive treatment
“Xerostomia, or oral dryness, is one of the most common complaints experienced by patients who have had radiotherapy of the oral cavity and neck region. The hallmarks of radiation-induced damage are acinar atrophy and chronic inflammation of the salivary glands. The early response, resulting in atrophy of the secretory cells without inflammation, might be due to radiation-induced apoptosis. In contrast, the late response with inflammation could be a result of radiation-induced necrosis. The subjective complaint of a dry mouth appears to be poorly correlated with objective findings of salivary gland dysfunction.
Xerostomia, with secondary symptoms of increased dental caries, difficulty in chewing, swallowing and speaking, and an increased incidence of oral candidiasis, can have a significant effect on the quality of life.
At present, there is no causal treatment for radiation-induced xerostomia…”
Effect of True and Sham Acupuncture on Radiation-Induced Xerostomia Among Patients With Head and Neck Cancer
“Conclusions and Relevance This randomized clinical trial found that TA (true acupuncture) resulted in significantly fewer and less severe RIX symptoms 1 year after treatment vs SCC…”
PubMed Appendix
- Radiation-induced xerostomia overview
PubMed Study - Xerostomia pathophysiology review
PMC Review - Supportive treatment review
PMC Article - Prevention and treatment review
PMC Study - Recovery factors after xerostomia
PMC Prognostic Study