Cancer Therapy and Oral Complications



Most often, cancer therapy consists of chemotherapy and radiation. Treatment of cancer, whether with chemotherapy or radiation can affect the oral tissues in a significant manner. The affect of these treatments can be so severe, that the persons’ quality of life may be compromised. Complications may result in inflammation and ulcerations of the mouth tissues, infections, severe dry mouth, difficulty in swallowing, speaking, or eating, and taste alterations.

The risk of these complications increase if the therapy consists of radiation of the head and neck area. Rampant cavities in the teeth may begin within 3 months following radiation therapy of these areas. Other individuals most often affected, are those undergoing blood and marrow transplantation, or radiation for oral, pharyngeal and laryngeal cancer.

To reduce the risk of these complications, certain preventive measures have to be implemented by the dentist and the patient. Pretreatment would include a visit to the dentist for evaluation and treatment of problem or potential problem areas. Patients undergoing head and neck radiation therapy should use supplemental fluoride. Several days before radiation therapy begins, patients should start a daily 5-minute application of a 1.1% fluoride gel or a 4% stannous fluoride gel worn in the mouth with a custom tray. Those patients that don’t like to wear the trays can use the same concentration of fluoride gel and brush it on their teeth, after regular brushing and flossing. No eating or drinking for 30 min. after either delivery.

For those apposed to fluoride in any form, mouthwash and toothpaste containing xylitol will help prevent decay. Studies published by the Harvard School of Dental Medicine in Journal of Dental Education, indicate xylitol (from birch tree) “has demonstrated a consistent decrease in dental caries, ranging from 30 – 60 percent.” In another study published by the Department of Oral Diagnosis, at University of Connecticut School of Dental Medicine, “the literature not only supports the conclusion that xylitol is non-cariogenic but it is now strongly suggestive that xylitol is caries inhibitory, that is, anti-cariogenic in humans.”

Once radiation therapy has stopped normal oral care can resume, except patients whose salivary glands don’t function any longer due to prolonged radiation therapy. These individuals may have to continue daily fluoride applications for life.

Other helpful hints include: sipping water frequently, chewing sugar with xylitol and preferably without saccharin. Grace Fibro-Smile Oral Healthcare Products contain xylitol, (no saccharine or alcohol) and are beneficial for those suffering from dry mouth, (888-883-4276).

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Avatar Written by Flora Parsa Stay DDS

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