Cancer treatments have side effects that show up on the mouth and teeth – but dentists are equipped to mitigate them.
Every day we have more information about the many ways dental health can affect the rest of the body. Research from the Harvard School of Public Health shows that oral hygiene practices can decrease the risk of stomach and colon cancers, for example.
A cancer diagnosis and its course of treatments can also have side effects that can be seen in the mouth and teeth. That’s why it’s important for patients with a cancer diagnosis to discuss their diagnosis with their dentist.
Together, patients and dentists can create a plan to keep their mouths healthy and deal with the side effects of cancer treatments such as medications, chemotherapy, or radiation.
Helping Patients Create a Plan
Patients with a cancer diagnosis can talk to their dentists to create a plan that keeps them on track with dental check-ups. Their plan can also include monitoring their oral health as they get through treatments such as chemotherapy and radiation.
Dr. Vishala Patel, DDS, explains, “Before treatment begins, we perform a comprehensive oral exam to address any existing issues, such as cavities or gum disease, to prevent complications. Patients with periodontal disease often need deep cleanings to reduce infection risk.”
Dr. Jessica Pharar, DMD, says, “It’s really important that your mouth is healthy before you start your treatment. A lot of the side effects from cancer treatments show up in your mouth. We can often screen and catch things for the patient before it can prevent them from finishing their cancer treatments on time.”
Typical recommendations from your dentist might include:
- Monitoring your mouth for any changes.
- Informing them of any bleeding gums, new aches, or soreness.
- Taking precautions that could help you avoid dry mouth.
- Visiting your dentist after completing cancer treatments to address any bone loss or changes in your mouth.
Know the Side Effects of Cancer Treatments on Your Dental and Oral Health
Chemotherapy and radiation are common courses of action for many cancer patients. These have various general side effects, including, but not limited to:
- Fatigue
- Hair loss
- Skin darkening or scarring on the part of your body being treated
- Nausea and vomiting
- Changes to your appetite
- Diarrhea
- Constipation
Some symptoms also specifically affect your mouth. Dr. Patel explains, “Cancer treatments can predispose patients to dry mouth, mucositis (painful mouth sores), increased infections, and a higher risk of tooth decay and gum disease.”
Chemotherapy
Dr. Patel explains, “Chemotherapy weakens the immune system, making the mouth more vulnerable to infections. Some medications, such as bisphosphonates, can lead to osteonecrosis of the jaw (ONJ), a severe condition where bone tissue dies.”
Dr. Pharar explains, “Chemotherapeutic drugs kill the rapidly dividing cells in our body. A lot of times tissues in the stomach and mouth are dying off rapidly because of the medication.”
During chemotherapy patients can develop mouth ulcers that range in symptoms as a result. These ulcers may appear roughly a week after starting chemotherapy and typically disappear after 2 weeks.
“There are over-the-counter products or prescription products that we can give our patients to help them get through the treatment,” says Dr. Pharar. Dentist-recommended rinses can help patients prevent or mitigate the discomfort of mouth ulcers when used before treatment.
According to Dr. Pharar, these ulcers can range in severity. “The first stage of these ulcers is discomfort. Maybe patients can’t eat spicy things. But they sometimes can’t eat anything by mouth at all.”
In these cases, feeding tubes can be inserted. Keep in mind that there are stages in between that dentists are equipped to help patients with.
Radiation
Dentists can also help you prevent, manage, or mitigate oral side effects of radiation. According to Dr. Pharar, these can include necrosis in the jaw. “These are more common in people who have head, neck, thyroid, and breast cancer.”
People whose face, teeth, and jaws face the radiation field might also experience damage to their salivary glands. “Your spit is your mouth’s natural way of cleaning itself. If we take away the function of those glands it makes you much more prone to getting tooth decay,” explains Dr. Pharar.
Certain chemotherapeutic drugs might also make it so that dentists can’t pull teeth from patients. This means patients have fewer choices if they experience tooth pain related to their cancer treatment.
When More Invasive Treatments Might Be Necessary
Cancers of all kinds can have an impact on your oral and dental health. However, oral and neck might require additional visits to your dentist, as there are many specialties within dentistry that can help cancer patients eat more comfortably and feel their best.
Dentists work with oncologists, can provide necessary surgeries, and are typically the doctors who assist with any reconstruction after a tumor is excised from the mouth or face area. This might also include prepping a palatal obturator, a device that can cover the roof of your mouth to make speaking more comfortable, for example.
Considerations for Pediatric Patients
Patients who are 12 years of age and under require slightly different kinds of monitoring. According to Dr. Patel, pediatric patients may face long-term repercussions to their dental health after they’re finished with treatment, especially if they dealt with head or neck cancer. A few effects that might be visible in teeth include:
- Enamel defects
- Shortened roots
- Delayed or missing teeth
- Slower growth of teeth
- Delays in bone and jaw development
That’s why it’s important for the littlest cancer survivors to receive proper care, fluoride treatments, and regular checkups.
In any case, constant communication with a dentist is key for cancer patients. Dentists are equipped and ready to help all patients stay on track with cancer treatments while making their mouth feel more comfortable during an already distressing time.
