Chemotherapy Side Effects on Dental Health

DISCLOSURE: Noelle Copeland RDH is an Oral Care Specialist and Dental Consultant who provides content for Brilliant Oral Care and Baby Buddy.

Oral side effects are common in cancer patients. Therefore, preventing and controlling potential oral side effects helps them the most as they prepare and journey through this challenging season. In addition, cancer patients are more likely to continue their treatment as prescribed when the side effects are addressed early and prevented whenever possible. This preparation provides a better quality of life during this timeframe.

Complications of chemotherapy.

• Inflammation.
• Easy bleeding in the mouth.
• Nerve damage.
• Inflamed mucous membranes in the mouth.
• Infections that happen in the mouth can travel through the bloodstream and reach cells all over the body.
• Taste changes.
• Dry mouth.
• Pain.
• Malnutrition.
• Dehydration.
• Tooth decay and gum disease.
• Slow healing and infection. Chemotherapy and radiation stop cells from dividing, slowing the healing process in the body and the mouth.
• Decrease in white blood cells, weakening the immune system.
• Oral Mucositis
• Fungal Infection/ Candidiasis

Oral Mucositis

Oral mucositis is swelling and damage of the mucous membranes that line the inside of the mouth and affect other parts of the gastrointestinal tract. Oral mucositis induced by chemotherapy will self heal in 2 to 4 weeks when no infection is present.

• Oral mucositis appears red, like a burn-type of sore or ulcer. Swelling of the other tissues in the mouth like the gums, the tongue, the roof of the mouth, the floor of the mouth, the lips, and inside the cheeks can also occur.
• Mucositis can cause pain, infection, and unusual bleeding, making oral care challenging or ineffective.
• Clean your mouth every 4 hours and more often if the mucositis worsens.
• Use an extra soft-bristle toothbrush.
• Replace your toothbrush often and keep a bulk supply available to make this process easier to do.
• Use water-soluble mouth gels to help keep the mouth moist; an example of this would be Xyligel.
• Pain Doctor in Texarkana is working hard to continue to offer comprehensive, high-quality treatment during this tough time.

Pain Relief for Mucositis

• Topical therapies for pain.
• Rinse before putting medicine on the gums or lining of the mouth.
• Wipe the mouth and teeth gently with a saltwater-soaked gauze to remove food debris.

When the mouth lining is damaged and perforated, infections can occur more quickly when in conjunction with a weakened immune system. Oral mucositis damages the lining of the mouth, which provides a gateway for bacteria and viruses to get into the bloodstream quickly. In addition, chemotherapy weakens the immune system, so even good bacteria is a potential problem when there are wounds and open sores in the mouth. Finally, infections occur more often during chemotherapy as white blood cell counts get lower. Those with low white blood cell counts for long periods have a higher risk of serious infections—treating oral disease before chemotherapy is vitally important.

For patients who experience gum disease while also receiving chemotherapy, treatment may include:

• Using medicated mouth rinses.
• Using peroxide mouth rinses.
• Brushing and flossing.
• Monitoring closely until a deep cleaning is a viable option.

Fungal Infection.

The oral environment of the mouth normally contains fungi that can live in harmony there without causing significant issues. However, when the immune system changes the mouth too rapidly, fungi can overgrow and become an infection that has to be treated.

• Antibiotics and steroid drugs are utilized often when a cancer patient has a low white blood cell count.
• Antibiotics and steroid drugs rapidly disrupt the oral microbiome, making it easier for fungi to overgrow.

Candidiasis is a fungal infection common in cancer patients receiving chemotherapy and radiation.

Symptoms include

• Burning.
• Pain.
• Taste changes.

Treatment includes

• Antifungal mouthwash.
• Antifungal palatal lozenges.
• Prescription drugs are used when oral therapeutics don't work.
• Treating all oral appliances must be included to treat the fungus: dentures, mouth guards, or removable partials.

Dry Mouth

Dry mouth occurs when salivary glands don't produce enough saliva. Salvia is essential and is needed for eating, swallowing, tasting, and chewing. It also contains enzymes, minerals, and nutrients that bathe and protect the teeth.

• Salvia washes the mouth, cleaning the teeth and gums, preventing acid from pooling and eroding teeth.
• Radiation therapy can damage salivary glands, causing them to function less or not at all.
• A stem-cell transplant can also damage salivary glands.
• When saliva is absent or drastically reduced, the mouth can get sores and irritation, inflammation, and swelling very quickly.
• The risk of tooth decay rises when someone has a dry mouth.

Malnutrition

Loss of appetite can lead to malnutrition. With any cancer treatment, there is a risk of malnutrition. When the side effects are severe enough, patients may completely lose their desire to eat or may find eating too painful or may be plagued with nausea and vomiting that render food an unappealing afterthought.
Hiring a nutritional counselor may be the most practical option during this challenging season of therapy.

Every patient is different, and so is every body. So many factors affect how a person can handle cancer therapy—their environment, mentality, physicality, and spirituality all play major roles in active care and recovery. If you or anyone you know is going through the throes of chemotherapy or radiation, be sure they have a solid support team because when they are at their weakest physically, it is when they will need help the most.

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Be sure to check out our selection of specialty toothbrushes for individuals with special needs. This includes our silicone toothbrushes that make oral care easy to start. Our DINOSAUR, PENGUIN, and DUCK character sonic toothbrushes make oral care fun. And our special soft toothbrush with our most extensive bristle count and the softest texture brush we offer.

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