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Dental Health During Cancer Treatment
Cancer treatments can affect your entire body, including your teeth
and gums. Side effects of treatment may include inflammation of
the mucous membranes in the mouth (mucositis), infections, taste
changes, dry mouth, pain, tooth decay, gum disease, and sores inside
your mouth.
Therefore, good dental health practices are especially important for people
living with cancer. Good communication is important, too. Make certain that
you inform your dentist about your cancer treatment. You should also inform
your oncologist about your dental history and any planned dental work.
As a patient living with cancer, you should:
- Schedule a dental exam and cleaning before cancer treatment
begins and periodically during the course of your treatment
- Discuss dental procedures, such as the pulling of teeth or
insertion of dental implants, with your oncologist before you
start your cancer treatment
- Have your dentist check and adjust removable dentures, if you
have them
- Tell your physician about any bleeding of the gums, pain, or
unusual feeling in your teeth or gums, or any dental infections
Regular dental hygiene is not that different for people with cancer
than it is for people who don't have cancer, but because cancer
treatments can affect the teeth and gums, it can be even more important.
If you have cancer, your routine dental hygiene should include:
- Brushing your teeth and tongue after every meal and at bedtime,
using a soft toothbrush and gentle stroke
- Gentle flossing once a day to remove plaque (if your gums bleed
or hurt, the area that is sore should be avoided, but the other
teeth still should be flossed)
- Keeping your mouth moist by rinsing often with water (many
medicines cause 'dry mouth,' which can lead to decay and other
dental problems)
- Avoiding use of mouthwash that contains alcohol
Use a mirror to check your teeth and gums daily for any changes, such as sores
or bleeding gums. If you notice a problem or a change, or experience pain in
your mouth, teeth, or jaws, report it to your dentist or oncologist immediately.
Osteonecrosis of the Jaw
Osteonecrosis (pronounced OSS-tee-oh-ne-KRO-sis) of the jaw is an uncommon
condition that may involve the loss, or breakdown, of the jaw bone. It can be
a serious condition. Symptoms include, but are not limited to:
- Pain, swelling, or infection of the gums
- Loosening of teeth
- Poor healing of the gums
- Numbness or the feeling of heaviness in the jaw
If you experience any of these or other dental symptoms, tell both your
oncologist and your dentist immediately and follow your oncologist's recommendations
regarding continuation of your cancer treatment. Your oncologist may refer you
to an oral surgeon or dental oncologist with experience in osteonecrosis.
To diagnose osteonecrosis of the jaw, doctors may use x-rays or
tests for infection (microbial cultures). Treatments for osteonecrosis
of the jaw may include antibiotics, oral rinses, and removable mouth
appliances. Minor dental work may be necessary to remove injured
tissue and reduce sharp edges of the bone. Surgery is typically
avoided because it may make the condition worse.
Scientists do not know exactly what causes osteonecrosis of the
jaw or how often it occurs. This disease has occurred in some cancer
patients receiving bisphosphonates. However, a causal relationship
between bisphosphonates and osteonecrosis of the jaw has not been
established. Some possible factors that may increase the risk of
osteonecrosis include:
- Radiation therapy to the head or neck
- Chemotherapy
- Steroid therapy (for example, cortisone)
- Underlying cancer
- Anemia (low blood count) and other blood related disorders
- Infection
- A history of poor dental health
- Gum disease or dental surgery (such as pulled teeth)
- Alcohol abuse or cigarette smoking
- Poor nutrition
- Poor blood circulation or clotting problems
Once your cancer treatment has started, if you experience pain in your mouth,
teeth, or jaw—or any other symptom of possible dental problems—tell
both your oncologist and dentist immediately.
Dental care is an important element of your overall cancer care.
Beginning as soon as possible after your cancer diagnosis, your
treatment team should involve your regular dentist or a dental oncologist
(a dentist who is specially trained to treat people with cancer).
- Be sure to tell your regular dentist that you are being treated
for cancer
- Update your medical history record with your dentist to include
your cancer diagnosis and treatments
- Provide your dentist and your oncologist with each other's
name and telephone number for consultation
Print form to record
information to give to your dentist and oncologist.
This document is for informational purposes and is not intended
as a substitute for medical professional help or advice, nor is
it intended as a recommendation for any particular treatment plan.
A medical professional should always be consulted for any health
problem or medical condition.
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