Dental Care Before and During Cancer Treatment
If you are about to start chemotherapy or radiation to the head and neck, see a dentist before treatment begins if you can. Treating infection and unstable teeth beforehand lowers the chance of a dental problem interrupting cancer care, and it gives you a plan for the mouth changes treatment can cause. Bring your oncology team's contact details so the dentist can coordinate timing and precautions with them.
Why see a dentist before cancer treatment?
Chemotherapy can lower your ability to fight infection, and radiation to the head and neck can permanently change saliva and the jawbone. A dental evaluation before treatment is the chance to:
Find and treat infection in teeth or gums before your immune system is suppressed.
Deal with teeth that can't be kept healthy. If a tooth needs to come out, it is much safer to remove it before radiation, with time to heal, than afterward.
Record a starting point so changes during treatment are easier to spot.
Start prevention early, such as prescription fluoride if your saliva is likely to be affected.
I coordinate this timing with your oncologist or radiation oncologist so dental care fits your treatment schedule. I also serve on the Head and Neck Tumor Board at Baptist MD Anderson, where specialists review cases together.
What mouth problems can cancer treatment cause?
Chemotherapy and radiation affect fast-growing cells, including the lining of the mouth. Common problems include:
Mouth sores (oral mucositis). Painful inflammation that can make eating and speaking hard. Read about evaluation of mouth sores.
Dry mouth. Radiation can damage the salivary glands, sometimes permanently. Saliva may become thick and scant, and cavities can develop quickly.
Infections. Yeast (thrush) and other infections are more likely when immunity is low.
Jaw stiffness. Radiation can tighten the chewing muscles and limit how wide you can open. This is radiation-induced trismus.
Taste changes, which often improve after treatment but don't always return fully.
What changes after head and neck radiation?
Radiation reduces blood flow to the jawbone. If a tooth is removed from bone that received a high dose, the bone may not heal. This is called osteoradionecrosis. For that reason, after radiation the goal is to keep teeth healthy enough that they never need extraction, and any surgery is planned carefully with your radiation history in mind.
Lower saliva also changes how fillings and crowns should be planned. I favor daily high-strength fluoride, closer follow-up and restorative materials chosen for a mouth with less natural protection.
What should you bring to a cancer-related dental visit?
Your current medication list
Your treatment plan and schedule, if you have it
Contact details for your oncology team
Any history of earlier head and neck radiation or surgery
Notes on changes in saliva, taste, mouth opening or soreness
Physicians can use our physician referral information to send records and coordinate timing.
How much time does the first visit take?
New-patient visits at our office are scheduled for two hours, normally an hour with me and an hour in hygiene. For a patient about to start cancer treatment, that time goes to the medical history, examination, any needed imaging and a plan that fits the treatment schedule.
Where can you get dental care during cancer treatment in Jacksonville?
Our office is at 3675 Hendricks Avenue, near San Marco. Read about our dental care around head and neck cancer, see what a recent study found about lower radiation doses and dry mouth, or contact the office at 904-398-1549 to arrange an evaluation.
Sources
National Institute of Dental and Craniofacial Research. Cancer treatments and oral health.
National Cancer Institute. Oral complications of cancer therapies (PDQ), patient version.
About the author. CJ Henley, DMD, is a general dentist in Jacksonville. His practice focuses on cosmetic and restorative dentistry, dental implants and dental care around head and neck cancer treatment. His role is dental care and coordination with your medical team. He does not provide cancer treatment. Meet Dr. Henley.
CJ Henley, DMD, PA · 3675 Hendricks Avenue, Jacksonville, FL 32207 · 904-398-1549
Updated October 2026.
Natural-Looking Front Teeth Crowns: An e.max Smile Case
How Dr. CJ Henley restored a teen's broken front teeth with natural-looking e.max crowns in two visits. A San Marco, Jacksonville cosmetic dentistry case.
Four e.max ceramic crowns on the upper front teeth (#7–10) by Dr. CJ Henley, Jacksonville FL
Four e.max ceramic crowns on the upper front teeth (#7 to #10), Dr. CJ Henley, Jacksonville, FL
A front-tooth crown looks natural when it matches the neighboring teeth in brightness, translucency, surface texture and shape. In this case, four all-ceramic e.max crowns replaced earlier repairs on a young patient's broken front teeth over two visits, about three weeks apart. The material helps, but the result mostly comes from planning and attention to detail.
For me, the best sign of success with a cosmetic restoration is that nobody notices it. The goal isn't simply whiter or straighter teeth. It's teeth that look like they grew there. Crowns or porcelain veneers that look flat, opaque or too uniform stand out from across the room, however well they fit.
The case: restoring four upper front teeth
This patient broke her upper front teeth when she was younger. As she approached high school graduation, it was time to replace the earlier repairs with something more permanent that looked like natural teeth.
We restored the two central and two lateral incisors (teeth #7 to #10) with all-ceramic e.max crowns. These are the most visible teeth in any smile, and there's nowhere to hide a mismatch in shade, shape or edge translucency. At the first visit, we prepared the teeth and placed temporary crowns. At the second, about three weeks later, we placed the final crowns.
The finished crowns blend with her natural teeth in color, light and texture. You can see more of our work in the before and after gallery.
What makes a crown look natural?
Natural teeth aren't one solid color. A more opaque inner layer (dentin) sits under a semi-translucent shell (enamel). Light passes into the tooth, scatters and comes back out. Crowns look artificial when they block that light or reflect it all off the surface. These are the details I check:
Translucent edges. The biting edges of front teeth let light through and often show a faint blue-gray tint. A crown that is equally dense from top to bottom looks chalky.
Brightness, not just shade. People usually notice that a tooth is too bright before they notice the wrong hue. I match brightness to the neighboring teeth and to your complexion.
Surface texture and luster. Enamel has fine ridges and growth lines that catch light. A glassy, perfectly smooth surface reflects like a mirror and gives a crown away.
Shape and proportion. In one study of extracted teeth, unworn upper central incisors were about 78 percent as wide as they were long, and worn ones about 87 percent. [1] Laterals are narrower and slightly shorter. Getting proportions right matters as much as color.
Healthy gums and clean margins. The gumline frames the teeth. Healthy tissue and a smooth transition from crown to tooth, with no dark line, keep the result convincing up close.
I photograph every case and send the photos to our ceramist, so the lab sees the color, translucency and character of your teeth, not just a number from a shade guide.
Why e.max crowns?
e.max is a brand of lithium disilicate, a glass-ceramic widely used for front-tooth crowns because it balances appearance and strength.
Lifelike translucency. As a glass-ceramic, it handles light much like enamel.
No metal underneath. Older porcelain-fused-to-metal crowns can show a gray line at the gum and look opaque. All-ceramic crowns avoid both.
Strong enough for front teeth. Lithium disilicate is considerably stronger than traditional porcelain.
Bonded to the tooth. It can be bonded rather than only cemented, which improves retention and can allow a more conservative preparation.
It isn't the right choice for every tooth. People who grind heavily, back teeth under high load and teeth with very dark underlying color may do better with another material such as zirconia (see our full-contour zirconia case). When a tooth can't be saved, a dental implant with a ceramic crown can be finished to the same standard. I choose materials case by case.
Crowns or veneers for front teeth?
Both can look natural. The deciding factor is how much healthy tooth structure is left.
Porcelain veneers cover the front surface and edge of the tooth. They suit teeth that are mostly healthy, where the concern is color, shape or minor spacing, and they need less tooth reduction.
All-ceramic crowns cover the whole tooth. They are the more predictable choice when a tooth has a large filling, an old crown, a root canal, a fracture or heavy wear.
A tooth with a large filling or old crown may not have enough sound enamel left for a veneer to bond well. Our cosmetic dentistry page covers the full range of options, from whitening and bonding to complete smile makeovers.
How I plan a natural-looking smile
Listen first. What bothers you about your smile, and what would you like to see? Some patients want a dramatic change. Most want to look like themselves on a good day.
Photographs and imaging. Clinical photographs and, when needed, 3D imaging show the teeth, bite and supporting bone.
Design the shape around your lips, face and gumline rather than a template.
Try it in temporaries. Temporary crowns let you live with the new shape before anything is final. We adjust them until they look and feel right.
Custom fabrication. The ceramist builds the final crowns from our photographs, shade notes and your approved temporaries.
Try-in and bonding. I check color, fit and bite in natural light before the crowns are permanently placed.
Caring for ceramic crowns
Brush twice a day and clean between your teeth daily. The crown can't decay, but the tooth underneath and the gumline still can.
Use a non-abrasive toothpaste to protect the glaze.
Don't use your front teeth as tools: no opening packages, biting nails or chewing ice.
If you clench or grind, wear a night guard.
Keep regular cleanings and examinations so we can check the margins and gums.
Frequently asked questions
How long do e.max crowns last?
Studies of lithium disilicate single crowns report about 98 percent still in service at five years. Ten-year data are more limited but also encouraging. [2] How long your crowns last depends on grinding, injury, gum health and home care.
Will my crowns stain?
Ceramic resists staining far better than natural enamel. It also won't whiten, so if you'd like brighter teeth overall, we whiten first and match the crowns to the new shade.
Will people be able to tell I have crowns?
That's what I work to avoid. Matching translucency, texture and shape to your own teeth is what makes crowns blend in.
Does getting crowns hurt?
The teeth are numbed during preparation, and most patients say it feels like getting a filling. Mild sensitivity for a few days afterward is common.
Does insurance cover cosmetic crowns?
Insurance often helps when a crown restores a damaged tooth, but rarely for purely cosmetic changes. We're an out-of-network practice and can help you understand how to use your benefits. You're responsible for any amount your plan doesn't pay. More answers are on our FAQ page.
Talk about your front teeth in Jacksonville
Dr. CJ Henley provides cosmetic and restorative dentistry at 3675 Hendricks Avenue in San Marco, Jacksonville. See more case studies, read patient reviews or look over our new patient information.
Book a consultation online, call the office at 904-398-1549, or text our practice's on-call line at 904-762-5616. Please don't send sensitive health information by text.
Sources
Magne P, Gallucci GO, Belser UC. Anatomic crown width/length ratios of unworn and worn maxillary teeth in white subjects. J Prosthet Dent. 2003;89(5):453-461. doi:10.1016/S0022-3913(03)00125-2 (retrieved via PubMed)
Pieger S, Salman A, Bidra AS. Clinical outcomes of lithium disilicate single crowns and partial fixed dental prostheses: a systematic review. J Prosthet Dent. 2014;112(1):22-30. doi:10.1016/j.prosdent.2014.01.005 (retrieved via PubMed)
About the author. CJ Henley, DMD, is a general dentist in Jacksonville whose practice focuses on cosmetic and restorative dentistry, dental implants and dental care around head and neck cancer. Meet Dr. Henley.
CJ Henley, DMD, PA · 3675 Hendricks Avenue, Jacksonville, FL 32207 · 904-398-1549
Updated October 2026.