 Radiation may directly affect taste buds but

changes in the saliva and smell can also affect

taste.
 Taste acuity is reduced or lost in about 2nd
and 3rd week of radiotherapy.
 In general, bitter and acid flavors are more
severely affected when posterior third of the
tongue is irradiated and salt and sweet when
anterior third is irradiated.
 Taste acuity usually decreases by a factor of
1000 to 10,000.
(cont’d)

 The loss of taste sensation may be permanent

in some patients.
 In some patients complete recovery of taste
usually occurs in 60 to 120 days following
treatment completion
 Practical management centers on minimizing
the occurrence of food aversion through patient
education and diet planning.
 Changes in the composition and consistency of
diet may be of benefit.
 Dry mouth is a frequent complication of
radiation therapy as salivary glands are very
sensitive to radiation.
 During radiotherapy salivary glands are at
times unavoidably exposed to 20-30 Gy.
 As previously noted up to a 90 % reduction in
saliva may occur when all 3 pairs of major
salivary glands are irradiated.
 Parotid gland more sensitive to radiation.
 The effect may begin within a week of
initiation of the radiation therapy.
 Extent of reduced flow is dose dependent and
essentially reaches zero at 60 Gy.
Effects of xerostomia
* marked decrease in salivary flow.
* Composition of saliva affected.
.
* mouth becomes dry,tender.
* pH of saliva decreases –may initiate
decalcification of enamel.
 These sequelae include:
1. A decrease in saliva with a concomitant
increase in viscosity.
2. Increased concentration of sodium chloride
calcium , magnesium ions and protein
3. A decrease in the pH of the oral cavity-may
initiate
4. decalcification of enamel.
5. Development of dysphagia.
6. Development of mucositis.
 6. A decrease in retention of removable prostheses
due to an increase in “sore spots”.
 7. Adherence of food and cellular debris to the oral
structures.
 8. A shift in the diet to softer foods, which are
usually carbohydrates.
 9. A shift of the microflora to include a greater
abundance of Lactobacilli, cariogenic Streptococci and
Candida.
 10.A compensatory hypertrophy of salivary gland
and xerostomia may subside after six to twelve
months after therapy.xerostomia that persist more
than a year is less likely to show return to normal.
 The patient should be instructed to:
 1. Rinse frequently with sterile water/saline.
 2. Use commercially available artificial saliva
substitutes.
 3. Use salivary stimulants such as sugarless
gum/candy or institute drug therapy.
 4. Apply lubricating agents to the lips to prevent
cracking.