Chemotherapy is an important part of your overall cancer treatment. But, according to the National Institute of Dental and Craniofacial Research, over a third of all cancer patients develop complications affecting the mouth because of their cancer treatment. Because oral complications can arise during chemotherapy, oral healthcare during chemotherapy and cancer treatment is important and you should take extra care to practice good oral health.
Chemotherapy and Dental Problems
Chemotherapy is the use of medications for treating cancer. These medications kill cancer cells, but they can also harm your normal cells, including the cells in your mouth.
Chemo and dental problems can go hand-in-hand. Chemotherapy can affect your teeth, mouth and salivary glands, which produce your saliva. Oral and dental side effects could make it hard to talk, eat, swallow or chew.
You’re more likely to get an infection, which could be dangerous when you’re having cancer treatment. If the side effects become severe, you might not be able to continue your cancer treatment. The doctor might cut back on your cancer treatment or stop it altogether.
Not all cancer treatments impact the teeth, mouth and jaw. But, some, like chemotherapy, might cause certain oral and dental side effects, including:
1. Gum Pain, Tooth Loss and Gum Disease
Sensitive gums might be a sign of mild tissue swelling from radiation and chemotherapy or a more severe indication of gum disease. Symptoms might include:
- Loose teeth
Chemotherapy can weaken your immune system, making your body susceptible to infection and bacteria. The bacteria in your mouth could spread to the rest of your body. This is why it’s so important to visit your dentist right after you receive a cancer diagnosis so you can have any potential existing gum disease treated before you undergo chemotherapy. Teeth breaking from chemotherapy side effects is a possibility.
You’ll want to get a dental health checkup and talk about treatment options with your dentist. They might suggest a steroid rinse or a topical anti-inflammatory. They might also prescribe an antifungal and antibacterial rinse. By ensuring your mouth stays healthy before you begin treatment, you can potentially decrease your risk of further infection that could delay your overall cancer treatment.
2. Mouth Sores
Mouth sores are ulcers that can form in or around your mouth, including your gums, tongue or lips and your soft tissue. Chemo or radiation can cause them. Usually, they are relatively mild, but if you develop more severe mouth sores, the doctor might suggest delaying your treatment until they heal.
Chemotherapy decreases the ability of your blood to clot and can lead to mild to severe mouth sore bleeding. Painful sores and bleeding can affect your ability to eat, causing more stress to your body.
Talk with your doctor about treatment options and get a dental checkup to obtain relief. Your dentist may suggest a topical treatment or coating agents that work by forming a protective film over your sores or pain relievers to numb the sores. Be careful when brushing or eating your teeth when you take numbing medicines since you might not be able to tell if you’re causing more damage. Fluoride toothpaste and other over-the-counter products containing allantoin and aloe vera are gentle and could help naturally soothe.
A mouth infection could present itself in various ways. The National Institute of Dental and Craniofacial Research (NIDCR) says you should contact your cancer healthcare team if you notice a sticky or sore white film in your mouth or if you experience bleeding or swelling.
Chemo lowers your immunity, which increases your chances of getting an infection from germs that naturally live in your mouth or of worsening any existing infections. These infections of the mouth can be hard to heal and if severe enough, could even delay your cancer treatment. So, you’ll want to do your best to prevent them from occurring in the first place.
If you develop an infection, see your dentist or doctor right away. They can prescribe you antibiotics to eliminate the infection.
4. Dry Mouth
Dry mouth occurs when you don’t produce enough saliva. Certain medications can cause this side effect, especially chemotherapy and head and neck radiation since they greatly decrease your saliva production by affecting your salivary glands directly. Dry mouth could cause:
- A burning sensation
- A constant sore throat
- Difficulty swallowing
- Trouble speaking
- Dry nasal passages
If you experience any of these side effects of a dry mouth, talk with your dentist. They may recommend a fluoride rinse or gel or the use of artificial saliva since dry mouth can cause tooth decay, and chemotherapy can cause dry mouth.
Pain can result from almost all oral issues. Your doctor might be able to prescribe you a pain reliever to manage the pain while trying to identify the underlying issue.
6. Difficulty Swallowing
Difficulty swallowing, also called dysphagia, occurs when you have trouble getting food or drinks to pass down your mouth or throat. You might gag, choke or cough when trying to swallow. You might feel like you have food stuck in your throat.
Dysphagia treatment options frequently take a compensatory approach or a rehabilitative one. They don’t typically solve the swallowing issue, but they can help you learn how to cope with it. For instance, treatment might include you having to turn your head a certain way so food can travel down your esophagus more easily. Or, you might need to change your food’s consistency so you can swallow your food more easily.
Rehabilitative approaches work by improving your ability to swallow, which leads to a lasting improvement. You might learn exercises that help to build your face and esophagus muscle strength, or you may learn a swallowing technique that keeps your airway blocked off. This would prevent your food from going down your trachea into your lungs. Then, there’s the supraglottic swallow technique where you hold your breath before you swallow to close your airway off.
7. Problems With Your Tongue
Your tongue may burn, peel or swell as a result of chemotherapy.
Protect Your Teeth Before Chemotherapy
Dental treatment is an important need before you begin cancer treatment. It can:
- Identify existing risk factors, such as a current or potential oral infection
- Provide you with oral hygiene care recommendations
- Provide you with oral treatment
1. See Your Dentist
To start, you should visit your dentist for an examination, preferably a month before you begin your cancer treatment to allow enough time for the dentist to address any dental issues and for the tissue to heal after you’ve received dental treatment. During this time, your dentist should take full mouth X-rays and a panoramic to look for any abnormalities like ongoing infections, periodontal disease or cavities.
Also, your dentist will give you an oral cancer screening to look for any potential signs of cancer that could be present in your mouth. They’ll need to extract any loose or hopelessly damaged teeth and remove any orthodontic braces at this time.
A pretreatment oral exam will help the dentist identify issues like fractured teeth, gum disease or loose fillings or crowns. Your dentist may recommend necessary tooth extractions before beginning chemotherapy. These issues also need to be addressed to help decrease your risk of complications.
During your visit, you should talk with your dentist about potential oral complications cancer treatment causes and ways you can improve your oral health during cancer treatment. You’ll also want to discuss ways of maintaining healthy nutrition and how to prevent and reduce risks of infection as well as any concerns you have with oral health.
2. Brush Your Teeth
Twice a day, use a fluoride toothpaste when brushing your teeth. Consider those that contain the allantoin and aloe vera mentioned earlier, after you’ve spoken with your dentist first. Use a soft-bristled toothbrush. Soak it in warm water if the bristles become too hard to make them softer. Remember to brush your tongue.
3. Floss Daily
Flossing daily will help remove the plaque between your teeth. If you have bleeding or sore gums, avoid those areas, but floss between your other teeth.
4. Rinse Your Mouth Often
Rinsing your mouth out can help keep debris and food off your gums and teeth. You can reduce your chance of infection and dental decay with regular brushing, flossing and rinsing often. Rinsing can also help after vomiting, which is a side effect of chemo, by keeping the acids from damaging your teeth enamel. You might also want to cut back on eating citrus fruit or other highly acidic foods.
You can make your own rinsing solution with any of the following:
- A teaspoon of salt mixed in four cups of water
- A teaspoon of baking soda mixed in one cup of water
- A half teaspoon of salt and two tablespoons of baking soda mixed in four cups of water
Dental education related to cancer treatment is helpful for proper oral health during your treatment.
Tips for Practicing Good Oral Health During Cancer Treatment
Dental treatment during chemotherapy is crucial. It can’t be stressed enough how imperative good brushing and flossing are. Cancer treatment compromises your immune system, therefore extra attention to daily oral cleanings can go a long way. Immediately see your dentist at the first sign of any type of oral complications due to cancer treatment.
Let your dentist know the types of cancer treatment you’re undergoing. In many cases, the dentist needs blood work 24 hours before dental care to measure immune system mediators and clotting factors. You may also require antibiotics as an infection preventative after dental hygiene care.
The following tips are recommended during cancer treatment:
1. Brush Your Teeth Gently Twice Daily, and Floss Regularly
Continue with proper oral hygiene practices. If your gums are sore, it might help to soften up the bristles on your toothbrush by soaking them in warm water before you brush. Prescription rinses are available that can help with oral pain linked with radiation and chemotherapy. You should also get a dental cleaning during chemotherapy.
2. Avoid Mouth Rinses With Alcohol and Extremes in Your Diet
Don’t rinse your mouth out with an alcohol-based mouth rinse — use one that’s alcohol-free instead. Choose soft and mild foods. Extremely cold, hot, acidic, spicy or crunchy foods might aggravate your mouth and could cause damage.
3. Promote Great Bone Health
Obtaining enough calcium and vitamin D every day can help promote healthy, strong teeth and jaw. Dairy products are good sources of calcium and vitamin D if fortified. You might also want to include fortified breakfast cereals and fortified fruit juices.
4. Drink Sugarless Drinks and Water
This can help manage a dry mouth. You can suck on candy sweetened with xylitol only or ice chips as an alternative. Avoid things that could cause cavities and dry your mouth out like fruit juice and soda. Your dentist can prescribe topical oral gels or rinses for dry mouth caused by chemotherapy or radiation therapy to the neck and head.
5. Eat Nutritious Food
Eating healthy food rich in nutrients and vitamins can help give your immune system a boost. Your individual calorie and nutrition needs will depend on your gender, age, physical activity and other health factors. A healthy diet should include grains, fruits and vegetables, fat-free or low-fat dairy and protein, such as skinless poultry, lean beef or fish. Vary your choices of protein too and also include beans, eggs, legumes and peas.
6. Avoid Tobacco Products
Tobacco products are harmful to your body, particularly the health of your mouth. Quitting smoking or using other tobacco products could help your body heal quicker.
7. Refrain From Eating Food With Sharp Edges
Don’t eat foods like tortilla chips which could potentially cut or scratch the inner lining of your mouth or gums. You might also want to avoid acidic foods and beverages and spicy food because they can irritate your mouth.
8. Avoid Using Toothpicks
Avoid the use of toothpicks during chemo since they could cut your mouth. If you cut or scrape your cheeks or gums, you’re at a higher risk of infection while undergoing chemotherapy.
Schedule Your Dental Appointment Today With Green Hills Family & Cosmetic Dentistry
Cancer and teeth problems are a real threat. Maintaining good oral health before, during and after chemotherapy or other cancer treatment could help reduce some side effects. Involving your dentist in your cancer treatment is important. If you visit your dentist before you begin chemotherapy, you could help prevent severe mouth issues. You’ll want to continue receiving ongoing oral examinations since the effects of chemotherapy can be far-reaching, and you may require dental treatment after chemotherapy.
Our dental office provides individualized treatment for your dental issues. From performing routine dental exams to cosmetic dentistry to providing ongoing dental before, during and after cancer treatment, we can help keep your teeth pain-free and healthy. Contact Green Hills Family & Cosmetic Dentistry if you have questions about your oral health.