Cancer treatments can cause side effects that affect oral health including impaired function of soft tissues of the mouth and teeth, bones, and salivary glands. This means that patients typically lose taste sensation, and have difficulty speaking, swallowing or chewing. However, it is possible to prevent these issues if you consult a dentist before the cancer treatment begins. Seeing your dentist will help diagnose and treat any existing cavities or oral health concerns. Different dental specialists manage different oral concerns such as oral oncologists, maxillofacial surgeons, periodontists and prosthodontists. Even well-trained general dentists can diagnose the presence of cancer or any other concerns that could impact your cancer treatment whether it is before, during, and after cancer treatment.
Dentists and their sub-specialists are well-trained in performing surgeries on the mouth and jaw, diagnosing and treating gum disease, and replacing teeth and other structures in the mouth and jaw.
Radiation therapy can affect the consistency of the saliva, increasing the risk of cavities, periodontal disease, and infection. Maintaining good oral hygiene and fluoride treatments can help protect your teeth. Exercise can prevent jaw stiffness. ORN, a rare but serious side effect can cause pain and exposed bone, which may require surgery or medication for treatment.
Most of these side effects occur when the cancer treatment is ongoing, however, they may start after the treatment is done. It is noteworthy, that even though these symptoms appear, they are reversible when proper care is taken.
After undergoing chemotherapy, any dental and oral side effects typically disappear quickly. These may include mouth sores, pain in the mouth and gums, peeling or burning of the tongue, infection, changes in taste, a temporary decrease in the body's ability to produce infection-fighting cells, and bleeding from the gums.
High-dose chemotherapy given before a bone marrow transplant may cause dental and oral side effects, such as mouth sores and those similar to chemotherapy. Graft-versus-host disease is a possible side effect of an ALLO bone marrow transplant that can lead to dry mouth, mouth sores, and an increased risk of tooth decay.
Bisphosphonates and newer drugs reduce the spread of cancer cells to the bone. and treat breast cancer and osteoporosis in cancer patients. A rare but serious side effect of using bisphosphonates is bisphosphonate-related osteonecrosis of the jaw. BRONJ can be managed with good oral hygiene, antibiotics, or surgery. Thus it is recommended to consult a dentist before starting cancer therapy to prevent the risk of BRONJ. Some targeted cancer therapies can cause canker sores, which can be treated with gels or rinses.
Some types of immunotherapy can cause mouth sores and salivary gland changes.
Other cancer medications may cause dental and oral side effects such as pain medications that can cause dry mouth. And some mouth rinses that are used to treat infections may discolour teeth.
Consider informing your dental team of doctors in case you experience any dental or oral side effects during your cancer treatment. They will help diagnose your condition by taking a complete medical history and advising tests as indicated. Some tests include oral biopsy, imaging scans, and oral biopsies as needed. The treatment of these side effects is termed palliative care or supportive care.
Director
Preventive Health
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