Your dental patient is about to start chemotherapy, is currently undergoing chemotherapy, or has completed chemotherapy. Are you looking for information to help you better understand what this means? If so, you have come to the right place!

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While chemotherapy differs in terms of type of drug or drugs and how it is delivered, it essentially refers to medications given to patients who have cancer to either kill cancer cells or prevent them from reproducing or allow greater effectiveness of other modalities. 

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Chemotherapy may be delivered by medical oncology teams via pill form or intravenously. It is typically given in a combined regimen with other medications, with the goal that each drug maximizes its benefit in eliminating the cancer yet, together the side effects are reduced. Regimens are based on long-term studies done at major cancer centers and are selected based on efficacy and safety.

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Drugs typically attack cancer cells which are rapidly reproducing. As a complication, healthy cells which by their nature rapidly reproduce may also be impacted, such as reproductive cells or lining epithelial cells. Which explains why mucosa or hematopoietic cells may be impacted. People undergoing chemotherapy may have significantly lower numbers of platelets and white blood cells which may impact clotting or ability to fight infection.

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Timing of regimens. Patients will have a schedule to receive chemotherapy, along with break times to allow for recovery of normal tissue. The time when the chemotherapy has had the strongest effect on the tissue is called the “nadir” and the lowest blood values are typically seen at this time. Dentists should work closely with medical oncology teams to determine when the patient is out of the nadir, as their ability to respond to dental treatment may be better.

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Bisphosphonates are a form of chemotherapy which may be given to individuals with risk of or presence of cancer metastasis in the bone. When given intravenously, it increases risk of medication-related osteonecrosis of the bone.

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Following chemotherapy, routine preventive oral care can be resumed to maximize oral health. While less common, secondary cancers may occur which means a comprehensive oral exam should be performed at each visit.
 

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For more information about chemotherapy and oral health, see these resources:

 

• Dental Provider’s Oncology Guide - National Institutes of Health

• Oral Complications of Cancer Treatment: What the Dental Team Can Do - National Institutes of Health 

• Oral Complications of Cancer Treatment: What the Oral Health Team Can Do - National Institute of Dental & Craniofacial Research

• Oral Complications of Cancer Treatment: What the Oncology Team Can Do - National Institute of Dental Craniofacial Research

• Oncology Pocket Guide to Oral Health - National Institute of Dental & Craniofacial Research

• Oral Complications of Cancer Care - National Cancer Institute

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You may wish to learn more about:

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• Finding & Financing Oral Health

• Oral Exam

• Mucositis

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More information regarding the following topics will be coming soon:
 

• Osteonecrosis 

• Dental Care and Home Care Before, During, and After Treatment

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