Dental Issues During and After Cancer Treatment by Barbara Cunnings-Versaevel

I must admit that I didn’t give any consideration to my teeth when I was diagnosed with cancer. It never entered my mind. However, during the years since my diagnosis and treatment, I have heard many stories of people having issues with their teeth and/or mouth while going through treatment and side effects after treatment.

To save you problems, I’d like to share some key points you might want to consider. These points are from an article posted by the National Institute of Dental and Craniofacial Research (NIH) on their website. The following information is from their website.

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What Are Oral Complications of Cancer Therapy?

Most people are aware of common side effects of cancer treatment like nausea and hair loss. But many don’t realize that more than one-third of people treated for cancer develop complications that affect the mouth. These problems may interfere with cancer treatment and diminish the patient’s quality of life.

Head and neck radiation, chemotherapy, and blood and marrow transplantation can cause oral complications ranging from dry mouth to life-threatening infections.

What Can Be Done to Reduce Their Risk and Impact?

The publication series “Oral Health, Cancer Care, and You” informs health care providers and patients about steps they can take before, during and after cancer treatment to reduce the risk and impact of these often painful side effects. The 12-piece series includes fact sheets and laminated pocket guides for dental and cancer professionals, patient education publications in both English and Spanish, and a wallet card for patients with space for the names and contact information of their health care team.

Three Good Reasons to See a Dentist BEFORE Cancer Treatment

1 – Feel better Cancer treatment can cause side effects in your mouth. A dental checkup before treatment starts can help prevent painful mouth problems.
2 – Save teeth and bones A dentist will help protect your mouth, teeth, and jaw bones from damage caused by head and neck radiation and chemotherapy. Children also need special protection for their growing teeth and facial bones.
3 – Fight cancer Serious side effects in the mouth can delay, or even stop, cancer treatment. To fight cancer best, your cancer care team should include a dentist.


Protect Your Mouth During Cancer Treatment

Brush gently, brush often
  • Brush your teeth—and your tongue—gently with an extra-soft toothbrush.
  • Soften the bristles in warm water if your mouth is very sore.
  • Brush after every meal and at bedtime.
Floss gently—do it daily
  • Floss once a day to remove plaque.
  • Avoid areas of your gums that are bleeding or sore, but keep flossing your other teeth.
Keep your mouth moist
  • Rinse often with water.
  • Don’t use mouthwashes that contain alcohol.
  • Use a saliva substitute to help moisten your mouth.
Eat and drink with care
  • Choose soft, easy-to-chew foods.
  • Protect your mouth from spicy, sour, or crunchy foods.
  • Choose lukewarm foods and drinks instead of hot or icy-cold ones.
  • Avoid alcoholic drinks.
Stop using tobacco
  • Ask your cancer care team to help you stop smoking or chewing tobacco. People who quit smoking or chewing tobacco have fewer mouth problems.


Tips to help you care for mouth problems

Sore Mouth, Sore Throat
To help keep your mouth clean, rinse often with 1/4 teaspoon of salt or 1 teaspoon of baking soda in 1 cup (8 ounces) of warm water. Follow with plain water rinse. Ask your cancer care team about medicines that can help with the pain.

Dry Mouth
Rinse your mouth often with water, use sugar-free gum or candy, and talk to your dentist about saliva substitutes.

Call your cancer care team right away if you see a sore, swelling, bleeding, or a sticky, white film in your mouth.

Eating Problems
Your cancer care team can help by giving you medicines to numb the pain from mouth sores and showing you how to choose foods that are easy to swallow.

If your gums bleed or hurt, avoid flossing the areas that are bleeding or sore, but keep flossing other teeth. Soften the bristles of your toothbrush in warm water.

Stiffness in Chewing Muscles
Three times a day, open and close your mouth as far as you can without pain. Repeat 20 times.

Rinse your mouth after vomiting with 1/4 teaspoon of baking soda in 1 cup of warm water.

Brush your teeth after meals and before bedtime. Your dentist might have you put fluoride gel on your teeth to help prevent cavities.

When to call your Dentist?

Take a moment each day to check how your mouth looks and feels.

Call your cancer care team when

  • you first notice a mouth problem.
  • an old problem gets worse.
  • you notice any changes you’re not sure

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I definitely wish I had had this information at the time of my treatment. Fortunately, I didn’t have any big issues other than an issue with neuralgia in my gums from an old injury. This happened during chemotherapy. Others I know had mouth sores during chemotherapy which were very uncomfortable. Other issues I’ve heard of happen when undergoing treatment for head and neck cancers.

There are huge ongoing issues that happen after treatment. These problems include:

  • dry mouth
  • no saliva
  • difficulty swallowing
  • difficulty breathing due to dry mouth
  • dental cavities and deterioration of enamel
  • and more.

Children get cancer. Their teeth are just forming. It is critical to ensure that treatment does not damage these young teeth impacting their growth.

For more information, I would advise you visit NIDCR and read their Oral Health, Cancer Care, and You Series –

Remember, that prevention is worth a pound of cure. Be proactive now that you know and make sure you have protected your teeth and mouth to the best of your ability.

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