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Because teeth develop slowly, these problems are more likely to develop in people who received chemotherapy over a prolonged period (several years) during childhood.
Taking care of teeth and gums is always important, and it is even more important if a patient had radiation or chemotherapy at a young age. If an individual's gums are not healthy, they can shrink away from teeth, causing infection in the bone supporting the roots. The bone can then dissolve away slowly, causing the teeth to become loose. This condition is called periodontitis, which means an inflammation surrounding a tooth. Periodontitis can be prevented by properly brushing the teeth and gums and by flossing between teeth at least once a day.
If a patient's permanent teeth do not develop normally, they may need caps or crowns in order to improve the function of their teeth. Sometimes reconstructive surgery is needed to correct poor bone growth of the face or jaw.
Radiation can sometimes make it difficult to open a person's mouth fully (trismus), or cause some scarring and hardening of the jaw muscles (fibrosis). Stretching exercises for the jaw may reduce fibrosis and improve the ability to open the mouth. A dentist will be able to instruct patients or refer them to occupational therapy to learn these exercises.
Crooked or small teeth may be improved by bonding. If braces are needed, a dentist will do a panorex X-ray of the teeth to see if the teeth, roots, and supporting bone are strong enough for braces.