The dental team plays a critical role in helping patients maintain oral health. This can often be challenging, especially in light of cancer therapy. This page is about maintaining good oral health before, during, and after. Each time has a different emphasis. 

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Before: There are Three Good Reasons to See a Dentist BEFORE Cancer Treatment
1.    Feel Better. Cancer treatment can cause side effects in your mouth. A dental checkup before treatment starts can help prevent painful mouth problems.
2.    Save teeth and bones. A dentist will help protect your mouth, teeth, and jaw bones from damage caused by head and neck radiation and chemotherapy. Children also need special protection for their growing teeth and facial bones.
3.    Fight cancer. Serious side effects in the mouth can delay, or even stop, cancer treatment. To fight cancer best, your cancer care team should include a dentist.

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This is the time to address any potential sources of infection. During chemotherapy, for example, your immune system may have less ability to manage infection should one arise. In the case of radiation therapy to the head and neck, wound healing is more difficult after radiation, so it is best to address dental problems beforehand. Dental treatment before cancer therapy is about reducing the likelihood of future problems.

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During: Depending on the type of treatment, dental care during cancer treatment may be palliative only, to help make sure you are comfortable to continue treatment to fight cancer in a healthy way.

 

 But there are things you should do to protect your mouth during cancer treatment:

•    Brush gently, brush often
      Brush your teeth—and your tongue—gently with an extra-soft toothbrush.
      Soften the bristles in warm water if your mouth is very sore.
      Brush after every meal and at bedtime.
•    Floss gently—do it daily
      Floss once a day to remove plaque.
      Avoid areas of your gums that are bleeding or sore, but keep flossing your other teeth.
•    Keep your mouth moist
      Rinse often with water. 
      Don’t use mouthwashes that contain alcohol. 
      Use a saliva substitute to help moisten your mouth. 
•    Eat and drink with care

      Choose soft, easy-to-chew foods. 
      Protect your mouth from spicy, sour, or crunchy foods. 
      Choose lukewarm foods and drinks instead of hot or icy-cold ones. 
      Avoid alcoholic drinks. 
•    Stop using tobacco
      Ask your cancer care team to help you stop smoking or chewing tobacco. People who quit smoking or        chewing tobacco have fewer mouth problems.

Here are some tips to help you care for potential mouth problems during treatment: 
   

• Sore Mouth, Sore Throat

  • To help keep your mouth clean, rinse often with ¼ teaspoon of salt and ¼ teaspoon of baking soda in 1 quart (4 cups) of warm water. Follow with a plain water rinse. Ask your cancer care team about medicines that can help with the pain. 

• Dry Mouth

  • Rinse your mouth often with water, use sugar-free gum or candy, and talk to your dentist about saliva substitutes. 

• Infections

  • Call your cancer care team right away if you see a sore, swelling, bleeding, or a sticky, white film in your mouth. 

• Eating Problems

  • Your cancer care team can help by giving you medicines to numb the pain from mouth sores and showing you how to choose foods that are easy to swallow. 

• Bleeding

  • If your gums bleed or hurt, avoid flossing the areas that are bleeding or sore, but keep flossing other teeth. Soften the bristles of your toothbrush in warm water. 

• Stiffness in Chewing Muscles

  • Three times a day, open and close your mouth as far as you can without pain. Repeat 20 times. 

• Vomiting

  • Rinse your mouth after vomiting with ¼ teaspoon of baking soda in 1 cup of warm water. 

• Cavities

  • Brush your teeth after meals and before bedtime. Your dentist might have you put fluoride gel on your teeth to help prevent cavities. 

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When should you call your cancer care team about mouth problems?

Take a moment each day to check how your mouth looks and feels. 
Call your cancer care team when 
--you first notice a mouth problem. 
--an old problem gets worse. 
--you notice any changes you’re not sure about. 

 

After: Dental treatment after cancer therapy focuses on prevention of disease and restoration/rehabilitation in case there is need.

For example, if an individual had to have a tooth removed prior to cancer therapy, they should think about whether it would be helpful to replace the tooth. Not every tooth needs to be replaced, but in many cases replacing a tooth can improve function and increase self-confidence.

The above material was adapted from:
Oral Health, Cancer Care, and You: Fitting the Pieces Together. U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Dental and Craniofacial Research. https://www.nidcr.nih.gov/sites/default/files/2020-06/reasons-dentist-cancer-treatment.pdf