Dental Health During Cancer Treatment

February 17, 2010
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In this podcast, we'll talk about the types of cancer treatments that may cause oral side effects, as well as the ways people with cancer can prevent and manage such dental problems.

Transcript: 

You’re listening to a podcast from Cancer.Net. This cancer information website is produced by the American Society of Clinical Oncology, known as ASCO, the world’s leading professional organization for doctors that care for people with cancer.

Our topic today is dental health during cancer treatment.                                         

Dental health is a topic that may be overlooked in preparation for and during cancer treatment. Dental health, also called oral health, includes the well-being of not just the teeth, but also the entire mouth. This includes the gums, the lining of the mouth, and the glands that produce saliva, called the salivary glands.

In this podcast, we’ll talk about the types of cancer treatments that may cause oral side effects, as well as the ways people with cancer can prevent and manage such dental problems.

About one-third of people with cancer each year may develop oral or dental side effects due to treatment. These side effects may make it difficult to eat, talk, and swallow.

Fortunately, most dental side effects can be prevented or managed with the help of your health care team, including your oncologist, nurses, dentist, and possibly other dental specialists. It’s important to regularly talk with all members of this team before and during treatment to learn about the possible side effects of your specific treatment plan and whether they can affect any parts of your mouth.

Oral side effects may include dry mouth, infection, mouth sores, inflammation or pain in the lining of the mouth and tongue, and difficulty swallowing and talking. Some side effects may disappear shortly after treatment is finished, while others may last longer.

Not all types of cancer treatment cause oral side effects. Treatments that frequently cause dental problems are radiation therapy to the head or neck area, chemotherapy, and stem cell transplantation, also called bone marrow transplantation.

Let’s briefly look at each treatment type. Radiation therapy to the head and neck can cause dry mouth from radiation damage to the salivary glands. Other side effects may include an increase in tooth decay, loss of taste, mouth and gum sores, and stiffness in the jaw. Nearly all patients receiving radiation therapy to the head and neck develop side effects, and they can range from temporary problems to effects that continue for several years after treatment.

Chemotherapy can cause mouth sores, pain in the mouth and gums, a peeling or burning tongue, infection, and changes in taste. More than one-third of patients receiving standard doses of chemotherapy have such dental side effects. They usually occur only during treatment or for a short time after treatment ends.

Stem cell or bone marrow transplantation also routinely causes oral side effects. Often, high-dose chemotherapy is part of the transplant process, and more than two-thirds of patients receiving high-dose chemotherapy experience dental side effects. People with leukemia, lymphoma, or multiple myeloma receiving a stem cell transplant may be given a drug called palifermin (PAL ee FER min) before treatment to prevent mouth sores.

Also, there can be diseases of the bone, such as osteoporosis or thinning of the bones, during treatment that cause teeth problems. Bisphosphonates, which are medications that slow the rate of bone thinning, may be used to treat osteoporosis and bone loss caused by cancer.

Now, we’ll discuss the things you can do to help prevent dental side effects. This includes keeping your mouth and gums healthy, gently brushing your teeth two times a day, and flossing regularly. If you are receiving chemotherapy, your doctor may give you special instructions to reduce the risk of bleeding and infection.

In addition, schedule a dental exam and cleaning at least two weeks before starting any cancer treatment that is likely to cause oral side effects. Your dentist will look for any problems that need to be addressed before starting treatment. If you need any dental procedures, ask your dentist how soon after the procedure you can start cancer treatment. If you have already started treatment without an exam, see your dentist as soon as possible.

It’s also important to practice habits that support the strength and overall health of your bones to help maintain dental health. Strong and healthy bones support a strong and healthy jaw, which supports strong and healthy teeth.

To promote good bone health, many doctors recommend 1000 international units of vitamin D and 1000 milligrams of calcium each day. Dairy products such as milk and yogurt are good sources of calcium and, if fortified, Vitamin D. Be sure to talk with your doctor before taking any supplements.

If dental side effects from your cancer treatment do occur, talk with your doctor. This may include any pain or bleeding, difficulty in opening your mouth, or swelling in the mouth. Things that can be done to treat such side effects include mouth rinses that contain salt and soda; pain medications to help treat mouth sores; and antibiotics, antiviral drugs, or antifungal drugs to treat infections.  In addition, prescription or over-the-counter medications may also be recommended to treat dry mouth from radiation therapy.

Also, drinking water and sugarless drinks and sucking on ice chips may help manage dry mouth. Avoid drinking soda and fruit juice, and don’t smoke, chew tobacco, or drink alcohol, because these substances dry out the mouth.

It’s important to consider your dental health when preparing for and undergoing cancer treatments that may cause oral side effects. Knowing how to prevent and manage these side effects will help you maintain a healthy mouth.

For more information on this topic, contact your doctor or visit www.cancer.net. Thank you for listening to this Cancer.Net podcast.