A dental visit is probably the last thing on your mind if you’ve been told you have cancer. However, 40% of chemotherapy patients develop oral complications. With a bone marrow transplant, the number goes up to 75% and radiation to the head or neck region almost ensures oral problems. These oral complications can interfere with your cancer treatment schedule, so your dentist and your cancer doctors need to work together. Your dentist will help protect your mouth, teeth, and jaw bones from damage caused by radiation and chemotherapy.
Ideally, you should see your dentist for an exam and cleaning before starting cancer treatment. Some dental care, such as tooth removal, is best done beforehand because cancer treatments can change your jaw bone, and any areas of dental infection need to be resolved so that they will not cause a problem when your immune system is depressed during cancer therapy. While nothing can guarantee that you won’t have some oral side effects from cancer treatment, having a healthy mouth minimizes them. Pre-treatment oral care reduces the risk of severe oral complications including pain, improves the likelihood that you can have the optimum schedule and dose for your cancer treatment, prevents or reduces later instances of bone necrosis, and generally improves your quality of life while undergoing cancer treatment.
The most common oral complications are:
- Inflammation of the tissues of your mouth—results in soreness or ulcerations and increases the risk of pain, local or systemic infections, and poor nutrition.
- Infection—results from the combination of the depressed immune system and damaged soft oral tissues that allow bacteria, viruses and fungi to enter your body.
- Dental decay and tooth erosion—results from acids in vomit, from changes to the amount and type of saliva or from radiation to the head or neck region.
- Dry Mouth—results from changes to amount and type of saliva or damage to the salivary glands.
- Bleeding—results from low platelet levels and provides an opportunity for bacteria, viruses and fungi to enter your bloodstream.
- Taste Alteration—results from changes to saliva and from medications and can range from mild to severe to loss of taste. May contribute to nutritional deficiencies.
Besides the dental visit you should make before starting any treatment, you can also care for your teeth and mouth at home. Your dental hygiene routine should include gently brushing your teeth and tongue with a soft toothbrush after every meal, after vomiting, and at bedtime; gently flossing your teeth once a day; keeping your mouth moist by rinsing often with water and checking your teeth and gums daily so you can report any changes to your dentist and cancer doctor immediately.
Severe mouth sores that are significantly interfering with your nutrition or quality of life may need to be treated with a soft tissue laser on an “oral bandage” setting. For less severe sores, treatments include prescriptions to numb the pain so that you can eat more comfortably.
Your dentist will be able to recommend specific products for you to use and your cancer care team may also recommend that you use a custom tray to apply fluoride to your teeth at home for the duration of your treatment to combat the effects of dry mouth, acidic vomit, and radiation treatment. Your dentist can make this tray for you.
You should also continue dental visits during your cancer treatments. Timing of these visits may need to be coordinated between your dentist and your cancer doctors.
Hearing the words cancer, chemotherapy and radiation tend to overshadow everything else in your life. Understandably so. But continuing to see your dentist and having your dentist join your cancer team, can not only lessen long-term damage, but could ease some of the oral side effects of your treatments.
*Note: The information in this article is not meant to replace the clinical judgement of your healthcare providers.
Dr. Jennifer Robb is a general dentist and cancer survivor. Her office is located at 1320 Cooper Foster Park Rd, Lorain, OH 44053.
Call 440-960-1940 to reserve an appointment time.