Your life has suddenly turned upside down. You just learned you have cancer and you're struggling to understand the diagnosis, the prognosis and how your life is about to change.
One of the first recommendations by your doctor may surprise you. Many oncologists recommend cancer patients see a dentist to correct any problems with your teeth or gums before you start radiation or chemotherapy treatments. More than one-third of people treated for cancer have side effects that affect the mouth, the National Institutes of Health reports.
Before Cancer Treatment Begins:
Have your dentist call your oncologist. It's important your health team communicates with each other, especially if your treatment plan includes chemotherapy or radiation near your head or neck.
Visit the dentist at least one month before treatment begins to ensure problems such as tooth decay and periodontal disease are under control. "Chemotherapy makes things like a patient's ability to fight disease more difficult by affecting his or her white blood cells," said Dr. Dale Salomon, an oral surgeon who practices at several Coast Dental offices in and near Tampa, FL. "It is best to take care of problems such as a root canal or a tooth extraction prior to starting chemotherapy since one’s immune system gets suppressed."
Patients who will be undergoing neck or head radiation may have other oral complications. Radiation decreases oxygen supply to a bone, which directly affects healing post-surgically and often results in loss of bone due to the poor ability to heal. Extractions should be performed before radiation therapy. If the extractions happen after, a patient might have to go for hyperbaric oxygen therapy which is time consuming and costly; otherwise, a condition of bone death, called osteoradionecrosis may occur. Your dentist will take x-rays, determine if you need extractions, fillings and show you how to take care of your mouth to prevent side effects. Also, your dental team will show you jaw exercises that can help prevent jaw stiffness.
Common Side Effects During Treatment:
Patients undergoing chemotherapy or head and neck radiation may experience these side effects:
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Mouth sores
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Dry mouth
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Swollen tongue
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Change in taste
What Patients Can Do:
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Check your mouth every day for sores and alert your dentist if one develops
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Alleviate dry mouth symptoms by drinking a lot of water, chewing sugarless gum, or using a dentist-recommended medication to increase saliva production
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Brush your teeth¸gums and tongue with an extra-soft toothbrush after every meal
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Use a fluoride toothpaste
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Your dentist may prescribe a fluoride gel to help prevent cavities
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Floss daily, gently
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Eat soft foods such as mashed potatoes, eggs, oatmeal and other dentist-recommended foods.
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Avoid foods that can cause cavities, including sugary foods like candy or soda
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Avoid smoking and tobacco products
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Alert your dentist if your dentures, braces bands or other appliances don’t fit well
Your dentist may recommend you have more frequent cleanings, perhaps as often as once a month or every other month, for the first six months after cancer treatment. It's important to keep your mouth healthy during this time when your immune system is weakened.
Dale Salomon, DMD, has been a practicing dentist since 1995 and is a member of the American Dental Association and American College of Oral & Maxillofacial Surgeons. He provides Oral & Maxillofacial Surgery services to patients starting at age 12. He is a native English speaker who is fluent is Spanish and knows some French and Russian. He practices at several Coast Dental locations including Carrollwood, Clearwater, Largo, Newberry Square in Gainesville, Sarasota Crossings, South Lakeland, South Tampa, Rutland Plaza in St. Petersburg, Town ‘N Country, and Wesley Chapel.
Reviewed by: Dale Salomon, DMD
Reviewed by: Charbel Klaib, DMD
Reviewed by: Cindy Roark, DMD