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Medically Compromised Patients Oncology Supporting Your Practice

Desert Mouth – Dry Mouth in Cancer Patients

A significant proportion of cancer patients who receive radiation therapy will develop a permanently dry mouth. This is especially common in head and neck patients. And though they may experience some recovery, saliva production may never return to what it was prior to radiation treatment. This leads to a higher risk of caries and can compromise the patient’s overall quality of life.

Dr. Jessica Metcalfe is a General Dentist and Education Director at Princess Margaret Cancer Centre, Toronto. In this interview with Dr. John O’Keefe, Director of Knowledge Networks at CDA, she outlines the key management strategies for ‘Desert Mouth’ patients, recommends best available treatment options, and stresses the importance of the role of the Family Dentist once the patient goes back to seeing them.

We hope you find the conversation useful. We welcome your thoughts, questions and/or suggestions about this post and other topics. Leave a comment in the box below or send us your feedback by email.

Until next time!
CDA Oasis Team

Full Conversation (11.29")


  1. Michael G Christensen August 11, 2020

    Thank you Dr Metcalf and Dr O’Keefe. Very nice presentation with easy to use suggestions.

  2. Peter Stevenson-Moore August 11, 2020

    Thank you for sharing valuable information. The product updates are interesting.
    In my experience, the importance of keeping water available, particularly at night, and for many, during speaking engagements, is not to be underrated. Your recommendation of a spray bottle that can be carried in the pocket is valuable. Water dispensed in a spray is far more effective at quickly moistening dry tissues, than is taking a sip, or “lump” of water from a glass. Tissues that have become glued together by dehydration of viscous saliva are far more easily separated with a spray. The frustration of knocking over a glass of water in a semi-wakeful state is also avoided!

    It interests me that xylitol has been so slowly adopted over the last forty years since its discovery as an anti-cariogenic agent by Scheinin et al. Do you find this material to be beneficial in effectively suppressing caries due to xerostomia?

    1. Jessica Metcalfe August 12, 2020

      Hi Peter! Thanks for your comments. I don’t think xylitol on it’s own can suppress caries. I think this is a good addition to the patient’s personalized regimen to help manage because of their now increased risk of caries due to xerostomia. Thus, it’s the combination therapy of xylitol, good (actually, great) OH, fluoride trays (which i talk about in another CDA Oasis with John) and seeing the dentist every 3 – 4 months for hygiene and recare exams. I think the personalized regimen and combination therapy is prudent. Hope that helps!

  3. Darcy Murphy August 12, 2020

    Great interview, thanks
    Any feedback on wearing trays at night with MI paste or Fluoride gel?
    Thanks for your time.

    1. Jessica Metcalfe August 12, 2020

      Hi Darcy,
      Great question!
      In another CDA Oasis (which can be found on John’s facebook page), I chat specifically about managing caries in the xerostomic patient. For every head and neck cancer patient, impressions are taken and the patient is instructed to use their Fl trays with 1.1% neutral sodium fluoride for 5 minutes every day, then no eating or drinking or rinsing for 1 hour afterwards. Check out John’s page for more information but that video should be posted here soon as well. Hope that helps!

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