Cancer treatment is increasingly effective, but the therapies themselves can significantly impact oral health, necessitating a collaborative approach between oncologists and dental professionals. Experts now recommend that individuals undergoing cancer treatment receive a dental checkup approximately four weeks before initiating therapy, if feasible, to address any existing dental issues and minimize potential complications.
Oral complications are common during and after cancer treatment, ranging from mucositis – inflammation of the mouth’s lining – to infections, salivary gland dysfunction, taste disturbances, and pain. These issues can be acute, developing during treatment, or delayed, appearing months or even years afterward. Modern cancer therapies, including chemotherapy and radiotherapy, often affect the oral cavity even when the tumor isn’t located in the head or neck region.
The National Cancer Institute (NCI) emphasizes the importance of routine and effective oral hygiene throughout the course of cancer treatment. Maintaining a clean mouth can reduce the severity and incidence of adverse oral effects. Dental professionals are increasingly viewed as integral members of the cancer care team, capable of protecting the mouth, teeth, and jaw bones from damage caused by radiation, and chemotherapy.
Specific oral care recommendations include gentle brushing with an extra-soft toothbrush, brushing the tongue, and flossing daily. If soreness is significant, toothbrush bristles can be softened in warm water. Patients should brush after every meal and at bedtime. Maintaining adequate oral moisture is also crucial, and sugar-free gum or candies can help stimulate saliva production. Dietary adjustments, such as choosing soft, easy-to-chew foods and avoiding spicy, sour, or crunchy items, can also alleviate discomfort.
Patients should be vigilant in monitoring their oral health and promptly report any changes or worsening problems to their cancer care team. This includes novel sores, swelling, bleeding, or a white film in the mouth. Specific interventions are available for common side effects; for example, rinsing with a baking soda and salt solution can help manage a sore mouth and throat, even as saliva substitutes can address dry mouth.
Delaying or halting cancer treatment due to oral complications is a serious concern. A proactive dental assessment and ongoing oral care can help prevent these disruptions, optimizing the effectiveness of cancer therapy. The CDC and NCI, in partnership with other organizations, have developed resources for both healthcare professionals and patients to manage and prevent oral complications associated with cancer treatment.
Individuals experiencing stiffness in their chewing muscles are advised to perform mouth-opening exercises three times a day, repeating each exercise 20 times, within their pain tolerance. Rinsing the mouth after vomiting with a baking soda solution is also recommended. Regular dental checkups and diligent oral hygiene practices remain essential for preventing cavities during cancer treatment, and dentists may recommend fluoride applications.
