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Radiation Therapy Treatment to the Head and Neck

Approximately two weeks after your first treatment you may begin to experience side effects, or symptoms caused by radiation therapy. These symptoms may continue throughout the treatment period. And gradually disappear during or after you have completed treatment. Your doctor will tell you which symptoms you are likely to experience, when you will notice them and how long you will experience them. It is important to follow the appropriate instructions to minimize your discomfort.

  1. Before treatment, you need to see your dentist for an evaluation. This includes inspection, polishing, scaling (if indicated), flossing and repair or restoration of existing teeth.
  2. Your dentist will provide you with a fluoride treatment regimen to include a fluoride tray and fluoride gel. Sometimes a fluoride rinse is recommended. Ask your Radiation Oncologist when to start fluoride treatment.

Following the instruction listed below:

  • Clean mouth thoroughly with a soft toothbrush
  • Rinse mouth well with water
  • Apply one drop of fluoride gel into each depression on the inside of the lower and upper applicator.
  • Place applicator in mouth, press into position over the teeth and leave in position for five (5) minutes.
  • Remove applicator after five (5) minutes
  • Do not eat, drink or rinse your mouth for the next thirty (30) minutes.
  • Clean both applicators under running water, towel dry and store in a dry space.
  • Continue fluoride treatments after your treatment is completed and do not discontinue unless advised by the Radiation Oncologist.
  • Take analgesics (pain medication) as ordered.

During treatment the mucous membranes inside the mouth become dry and inflamed. This results from treatment to the salivary glands, which are located in the mouth and upper neck. These salivary glands normally produce approximately one or one and one half quarts of saliva daily, which bathes and cleans the teeth and provides moisture to facilitate chewing and swallowing. As a result, your saliva can become thick and your tongue can become coated.

  1. Use a humidifier or vaporizer in your main living area during the day and in your bedroom at night.
  2. Chew sugarless gum or suck on sugarless candy for oral lubrication. Lemon lozenges will stimulate saliva production.
  3. We suggest you try to drink four to eight (4-8) ounce glasses of fluid per day. You may want to carry a small plastic bottle or water in your purse or pocket when you leave home
  4. Artificial saliva may be ordered by your doctor if dryness is severe.  
  5. Follow instructions to rinse frequently with baking soda and salt water mixture.


  1. The taste buds line the surface of the tongue. As a result of the treatment, foods and liquids lose or change their taste resulting in a bitter, metallic or chalk-type taste. You may not enjoy your foods, however, it is essential that you maintain adequate nutrition and fluid intake. Usually after treatment your taste returns slowly over a period of months. Failure to have proper nutrition during treatment may result in weight loss and a decreased tolerance for treatment, which may include worsening of side effects.
  2. Meat commonly becomes distasteful after several weeks of treatment. If you are unable to tolerate it, be sure to supplement this source of protein by eating fish, poultry, eggs, cheese or milk products.
  3. Foods that are slightly chilled may be better tolerated, such as milkshakes, Jell-O®, pudding, etc.


  1. When your voice starts to become hoarse, rest it as much as possible.
  2. Restrict the use of your voice for the remainder of the treatment period and for one month after the completion of treatment. This will promote the healing of your vocal cords and return of a good quality voice.

Your skin will probably "sunburn" to varying degrees depending upon your skin's tolerance to treatment. Washing gently with any unscented soap that also moisturizes (Dove®, Tone®, Caress®, etc. - Ivory® tends to be very drying), will help to keep your skin clean and reduce chance of infection. Applying pure Aloe Vera gel three to four times daily, very sparingly to the treated area will soothe and protect your skin. Use the sap from an aloe vera plant or buy the clear, uncolored gel (no additives, no color).

If you must shave in the treated area, please use an electric shaver to reduce the risk of "nicking" or scraping your skin thereby opening an "avenue of infection."

Please contact your nurse for any questions or concerns you may have. The phone number is (631) 444-2328, Monday through Friday, 8:00am - 4:30pm. Evening, weekends and holidays please call (516) 783-1610.