Dental care during and following chemo is a subject I haven’t seen much about in cancer publications . So, I am pleased to share this post written by Steven E. Roth, DMD. Dr. Roth has been practicing dentistry, in New York City, for 26 years.
Chemotherapy affects more than a cancer patient’s digestive tract, bone marrow and hair follicles. Surprisingly, most people don’t realize that cancer treatment can also cause serious side effects in the mouth – infections, lifelong risk of dental decay, bleeding, burning mouth, stiffness, vomiting, functional difficulties, abnormal dental development, dry mouth, sore throat and more. If preventative action isn’t taken prior to the start of radiation and/or chemotherapy, the problems in the mouth may become exacerbated, leading to a delay or, worse yet, a premature cessation in the patient’s cancer treatment.
A qualified dentist should be brought onto the patient’s cancer care team prior to commencement of any treatment. Cancer patients are advised to schedule a dental hygiene visit and x-rays at least one month before starting chemotherapy or radiation. The purpose of the visit is to identify and eliminate sources of oral infections (cavities, periodontal disease, etc.), oral trauma and irritation, such as ill-fitting dentures or orthodontic appliances. To ensure that the patient’s mouth is healthy going into therapy, all invasive procedures must be completed 14 days prior to radiation and 7-10 days prior to chemotherapy. Any elective procedures, such as cosmetic dentistry, should be postponed until cancer treatment is completed.
The dentist will consult with the patient’s radiation oncologist to ensure that a tailored dental treatment plan is included in the patient’s overall cancer treatment regimen. This may include tooth extraction in the proposed radiation field, removing oral appliances, such as orthodontic bands, and/or tooth demineralization prevention through the use of custom gel-applicator trays and prescribed neural fluoride.
During cancer treatment, optimal oral hygiene is highly recommended. This includes the following:
- Brush teeth, gums and tongue gently after every meal and at bedtime. An extra-soft toothbrush and fluoride toothpaste is recommended. If brushing becomes painful, patients can soften the bristles using warm water.
- Floss teeth gently at least once daily, avoiding areas that bleed.
- Supplement dental regimen with prescribed fluoride gel applications.
- Rinse the mouth several times a day with a baking soda and salt solution, followed by a plain water rinse. The solution should contain ¼ tsp of each and approximately one quart of warm water. During mucositis, it’s suggested that patients omit the salt.
- Avoid candy, gum or soda (unless they’re sugar-free).
- Avoid spicy or acidic foods, tobacco and alcohol, including mouthwashes that contain alcohol.
- Exercise the jaw muscles throughout the day to prevent and alleviate pain associated with mouth stiffness.
Additionally, if patients experience dry mouth, it’s recommended that they sip water frequently, suck on ice or sugar-free candy or use a prescribed saliva stimulant.
Pretreatment oral care and optimal treatment during radiation and chemotherapy can prevent or minimize complications with the mouth, improve dental health and increase the patient’s overall quality of life short and long-term. It’s important for cancer patients to check their mouths daily for sores, signs of infection or other more acute side effects. Regular dental check-ups and open communication with the patient’s dentist and oncologist will ensure that all providers on the cancer care team have the information necessary to delivery the best possible care and mitigate any issues before they become dangerous.
About the Author:
Steven E. Roth, DMD, has been practicing dentistry in New York City for 26 years. He is a graduate of Columbia University and the University of Pennsylvania School of Dental Medicine. Dr. Roth is on the cutting edge of modern dentistry; He teaches cosmetic dentistry at the Spear Institute of Advanced Dental Education in Scottsdale, Arizona. Dr Roth regularly consults with the Motion Picture Industry. He has served on staff at the Beth Israel Medical Center, and lectured internationally on Cosmetic Dentistry, TMJ headaches, and Bruxism to other dental professionals. He is a member of the American Academy of Cosmetic Dentistry, the American Equilibration Society, and the American Dental Association. Dr. Roth is the WebMD Dentist – where he can be seen on Video in the Ask the Dentist series. He and has appeared on Inside Edition, as well as FOX news and other cable television shows, speaking on cosmetic dentistry. He is the inventor of the revolutionary CosmaLite process, which enables patients to experience porcelain veneers before committing to the full procedure. For more information on Dr. Steven Roth or his practice, please visit www.SmilesNY.com.
