Oral complications of cancer treatment

How can cancer therapy affect my mouth?
Of the 1.2 million Americans diagnosed with cancer each year, approximately 400,000 will develop oral complications from their treatment. All forms of cancer treatment, including radiation, chemotherapy and bone marrow transplant, can cause complications that affect oral health. In killing cancer cells, treatment also may harm normal cells. Healthy cells in the mouth are particularly vulnerable. Complications can make it hard to eat (which promotes poor nutrition) talk and swallow, and can increase the likelihood of infection.

How can oral complications affect my cancer treatment?
Oral complications of cancer treatment can be so debilitating that patients may tolerate only lower, less effective doses of cancer drugs, may postpone scheduled treatments, or may discontinue the treatment entirely. Oral complications also can be the source of infections that interfere with cancer therapy and threaten patient survival.

What are the side effects of cancer treatment?
Different people experience different complications. The most common include:
o Dry mouth
o Increased tooth decay
o Loss of taste
o Infections
o Jaw stiffness
o Painful mouth and gums
o Burning, peeling or swelling tongue

Why should my dentist be involved in my treatment plan?
You may be surprised to learn that your dentist is important in your cancer treatment. If you go to the dentist before radiation begins, you can help prevent serious oral health problems. Complications often occur because a patient's mouth is not healthy before cancer treatment begins. Not all mouth problems can be avoided, but the fewer oral complications you have, the more likely that you will stay on your treatment schedule. You should see your dentist at least two weeks before your first treatment. If you have already started treatment, see your dentist as soon as possible.

How can I keep my mouth healthy?
You can do a lot to protect your oral health during cancer treatment. The first step is to see a dentist before you start. Once treatment begins, it is important to look in your mouth every day for sores and other changes. If you find something unusual, call your dentist immediately. The following tips can help prevent and treat a sore mouth:
o Keep your mouth moist.
o Drink a lot of water.
o Suck on ice chips.
o Use sugarless gum or sugar-free hard candy.
o Use a saliva substitute
Clean your mouth, tongue and gums:
o Brush your teeth, gums and tongue with an extra- soft toothbrush after every meal and at bedtime. If it hurts, soften the bristles with warm water.
o Use a fluoride toothpaste.
o Avoid mouthwash that contains alcohol. Check the label for the list of ingredients.

Floss gently every day. If your gums bleed and hurt, avoid the areas that are bleeding or sore, but keep flossing your other teeth.

o Rinse your mouth several times a day with a solution of 1 /4 teaspoon baking soda and 1/8 teaspoon salt in one cup of warm water.

If your mouth is sore:
o Eat foods that are good for you and easy to chew and swallow.
o Take small bites of food, chew slowly and sip liquids.
o Avoid hard, crunchy and spicy foods, alcohol and tobacco.

Remember: See your dentist at least two weeks before beginning cancer treatment. It is crucial that your dentist is a well-informed member of your cancer treatment team. Working with your other health care providers, your dentist can help you avoid the painful oral complications that could cause you to discontinue your cancer therapy.

January 2001| AGD IMPACT