As the medical community grapples with a significant rise in HPV-related head and neck cancers among younger, non-smoking demographics, a local expert is sounding the alarm on a secondary, silent crisis: the rapid and devastating loss of dental health following life-saving radiation.
Dr. CJ Henley, DMD, a Jacksonville-based dental specialist on staff at Baptist MD Anderson Cancer Center, is calling for a radical shift in post-oncology dental protocols. He warns that the “routine” dental model—typically defined by six-month cleanings and standard oral hygiene—is dangerously insufficient for the biological reality of a post-radiation mouth.
The Myth of the “Healthy” Survivor
Historically, oral cancer patients were often long-term tobacco users with pre-existing dental issues. Today, the patient profile has shifted toward younger, healthier individuals who entered cancer treatment with impeccable oral health.
“This is where the false sense of security begins,” says Dr. CJ Henley. “These patients assumed their lifelong habits would protect them. But radiation fundamentally alters the biology of the mouth. Without specialized intervention, we are seeing patients with ‘perfect’ teeth experience total dental failure within just a few years of being declared cancer-free.”
Beyond Dry Mouth: A Permanent Biological Shift
Radiation-induced xerostomia (permanent dry mouth) is often dismissed as a side effect of comfort, but Dr. Henley emphasizes its role as a clinical catalyst for decay. Saliva is the mouth’s natural defense, buffering acid and delivering essential minerals. When radiation damages these glands, that defense is lost forever.
More critically, radiation alters the blood supply to the jawbone, specifically the mandible. This reduced vascularity turns routine dental procedures, such as extractions, into high-risk events that can lead to osteoradionecrosis—a severe, non-healing infection of the jawbone.
The New Gold Standard: Lifelong Intervention
To combat this, Dr. Henley is advocating for a mandatory, specialized standard of care for all head and neck cancer (HNC) patients:
- Mandatory Custom Fluoride Trays: Trays must be fabricated for every HNC patient, with a strict requirement for daily use for the rest of the patient’s life. Brushing alone cannot provide the sustained mineral immersion required to protect radiation-compromised enamel.
- The Three-Month Rule: Survivors should never return to a six-month recall. A three-month interval is the minimum required to catch and arrest rapid decay before it reaches the bone.
- Proactive Pre-Radiation Clearance: All high-risk dental work must be completed prior to the first dose of radiation, ensuring that the remaining teeth are structurally sound for a lifetime.
“The goal of oncology is to save the patient’s life,” says Dr. Henley. “Our goal as dental specialists is to ensure the life they’ve regained isn’t defined by the pain, expense, and trauma of avoidable dental catastrophe.”
About CJ Henley, DMD, PA
Dr. CJ Henley is a leader in restorative dentistry and oral oncology support in Jacksonville, Florida. A graduate of the University of Florida College of Dentistry, he serves on the Head and Neck Tumor Board at Baptist MD Anderson, collaborating with multidisciplinary teams to coordinate complex care for cancer survivors.
Dr. Henley is a former President of the Northeast District Dental Association and previously served as faculty in the Department of Oral and Maxillofacial Surgery at UF. His practice is built on the principle of clinical judgment over speed, focusing on long-term functional outcomes for medically complex cases.