Can chemotherapy cause dental issues?

Dental health can be complicated by cancer treatment.

Fighting a difficult battle with cancer means getting to terms with not only the reality of the illness, but also the side-effects of the cancer treatment you opt for. While chemotherapy's job is to kill cancer cells, it also destroys healthy cells necessary for basic human functions.

Chemotherapy, in general, causes a long list of side effects, including hair loss, fatigue, loss of appetite, infection and fever, itchy skin and bowel problems. Your dental health, specifically, can most definitely take a backseat when undergoing chemotherapy. The reason for this, is that chemotherapy's job is to kill cancer cells, but healthy cells are unfortunately also in the line of fire. It's important that you are aware of this, and take necessary precautions BEFORE starting treatment.

Basically, chemotherapy slows or stops the growth of fast growing cells. Cancer cells, in essence, are fast growing cells. But, normal cells in the lining of the mouth are also fast growers. Which means that any treatment against cancer can stop them from growing, too. This slows down the ability of oral tissue to repair itself by making new cells.

What's going on in there?

Inside your mouth is a healthy mix of (mainly) good bacteria. There are also harmful bacteria. Chemotherapy may cause changes in the lining of the mouth and the salivary glands. This, in turn, can upset the healthy balance of bacteria, which can lead to mouth sores, infections and tooth decay. You might find it difficult to eat, chew, swallow or even talk.

You are more likely to get an infection inside your mouth, which can be dangerous when you are receiving cancer treatment.

Here's a list of oral symptoms or side effects caused by cancer or its treatment:

  • Dry mouth.
  • Thickened saliva.
  • Changes in taste.
  • Mouth sores.
  • Tooth decay.
  • Difficulty swallowing.
  • Difficulty chewing or opening the mouth.
  • Infection.
  • Bone disease.
  • Inflammation or pain in the lining of the mouth and tongue.
  • Higher risk of tooth decay or gum disease.
Your mouth and gums may be more prone to infection during cancer treatment.Your mouth and gums may be more prone to infection during cancer treatment.

Stephen T. Sonis, (DMD, DMSc), a professor of oral medicine at the Harvard School of Dental Medicine, reiterates the importance of saliva in oral hygiene of which the production is affected during chemotherapy. Saliva helps keep the bacteria in your mouth off your teeth. If you don't produce enough saliva because of cancer treatment, plaque can build up more easily on your teeth. Plaque can cause tooth decay and gum disease.

In a medical article published by The National Center for Biotechnology Information, three researchers have studied the changes in oral flora during chemotherapy and its effects on the development of infections of the oral cavity. It's been found that gram negative rods (bacteria that cause infections) are present in patients undergoing chemotherapy. The researchers studied two leukemic patients who developed oral ulcers, while taking antibiotics. The Antibiotic treatment didn't seem to be doing its job. Sparing you the academic rumble, this study makes it clear that cancer patients undergoing chemotherapy might develop all sorts of oral health issues.

Children can be affected, too

Chemotherapy causes other side effects in children, depending on the child's age. The most common side effect is developing problems with their teeth. Permanent teeth may be slow to come in and may look different from normal teeth. The child's teeth may also fall out. It's important that the paediatric dentist check your child's jaw for any growth problems. Loose teeth, or those that may become loose during chemotherapy treatment, should be pulled by the dentist prior to chemotherapy.

While the above all sound absolutely horrific (as if coping with cancer isn't traumatic enough), there are certain remedies, preventions and treatments you can use for these mouth and oral issues caused by chemotherapy.

What you should do

As with many things in life: Prevention is better than cure. If you've maintained good dental health before undergoing chemotherapy, you'll have lower risk of developing the above mentioned side effects. Visit your dentist at least one month before starting any anti-cancer treatment so that any possible infections or irritations can be treated.

  • If you wear braces, consider having them removed prior to treatment. These could really irritate your cheeks and tongue in their already fragile states.
  • Ask your doctor for painkillers if the pain caused by mouth sores, broken teeth or tender gums become unbearable.
  • If you have dentures, make sure they fit absolutely well and snug, and are not irritating your mouth whatsoever.
  • Smoking or using any other tobacco products is a no-go.
  • Drink lots of fluids. This will help with the production of saliva.
  • Ask your health care team about fluoride rinses and gels. These can strengthen your teeth.
  • Make sure you have any teeth issues sorted out, like decayed, broken or infected teeth.

Keep the communication with your dentist and oncologist open and honest. It's also important that your dentist should talk with your oncologist to make sure that any dental treatment you receive is safe for you.

Switch out your regular toothbrush with a soft, child-size toothbrush. Soak the toothbrush in warm water to soften the bristles. Be gentle. This counts for flossing, too. If a lot of bleeding occurs when you brush or floss, be sure to tell your doctor. Additionally, it's prudent to:

  • Watch what you eat and drink. It might be wise to lay off the alcohol during this time, as it may irritate your mouth, along with extremely hot, cold spicy, acidic or crunchy foods. Sugar is the enemy the bacteria in your mouth use sugar to live, and this process makes the acid that causes tooth decay.
  • Stick to good, old school sunshine and healthy breakfast. Getting enough vitamin D and calcium each day helps your jaw and teeth stay strong and healthy.
  • Keep a bottle of cold water or sugar free drink nearby at all times. This may help manage a dry mouth. You could also suck on ice chips not only will it keep your mouth moist on the inside, it could also numb the pain temporarily.

Once you've found a good dentist, make sure you build a trusting relationship with him/her. The road to recovery can be a rocky one, and you'll need specialists you can rely one. You simply cannot go wrong with the team at City Dentists.