Dental Health While Undergoing Chemotherapy

Did you know that chemotherapy can affect your dental health? I only now realized the impact of chemotherapy on the health of my teeth. During a routine dental check-up, a new cavity that was extensive to the bone was noted under a crown. This reminded me that early in my chemotherapy experience, I also had an unsuccessful root canal that broke my tooth. I had not recognized the possible relationship to my chemotherapy. This made me realize that oral hygiene may be something that we do not think as much about while we are undergoing treatment for our blood cancer.

According to a literature review, the following are oral complications of chemotherapy: mucositis, infections, dental alterations, metallic taste, reduced salivary production, and dry mouth.¹ The chemotherapy may affect tooth enamel and increase the risk of dental problems. Dental care is an important consideration for patients before, during, and after chemotherapy.

Dental evaluation before chemotherapy

Oral complications may relate to pre-existing necrotic teeth (teeth with damaged nerves), advanced periodontal disease, or chemotherapy-induced mucositis, which is inflammation of the lining of the mouth.¹ These conditions may produce infections and fevers. Infections can sometimes necessitate an interruption of chemotherapy and can compromise the outcome of the cancer treatment. Be sure to notify your dentist about your cancer diagnosis so that you can schedule a visit if you haven't recently had an evaluation. Your dentist may want to see you before beginning treatment. The purpose of the dental evaluation is typically to identify any current or potential infections and often includes a thorough oral exam with radiologic evaluation.

Dental care during chemotherapy

The immune system may be compromised during chemotherapy, so a dental infection or dental procedure could have serious consequences. Your oncologist should be consulted before any dental treatment is begun.

Although oral care may be the last thing on your mind, it is important to not let our daily dental habits fall by the wayside. Oral care is important to minimize complications. Patients with dentures or partials must remove and clean them daily. All patients should brush their teeth 2-3 times a day with a soft toothbrush and floss teeth gently. Chemotherapy can cause also cause mouth sores. Avoiding alcohol-based mouthwashes and considering a mouth rinse with a solution of warm water and salt or baking soda might be helpful.

Considering dental work and care after treatment

After speaking with your oncologist, elective dental treatment may be provided. Ongoing oral hygiene and dental check-ups should be continued throughout treatment and after treatment concludes. Discuss with your dentist the use of fluoride therapy, which may make tooth enamel more resistant to decay, or any other precautions that can be taken throughout your treatment.¹ Patients who are experiencing dry mouth can talk to their doctor about increasing fluid intake and trying sugar-free candy to help stimulate saliva production. I am currently using a mouthwash that is advertised to reduce dry mouth and hopefully my next dental exam will be a positive one. Upon completing treatment, connect with your dentist about any additional follow up that may be needed, as some care may be delayed while you are undergoing treatment.

As patients, it is important to stay aware of how treatment for our blood cancer can impact our dental health. By communicating with your oncologist and your dentist throughout your treatment, you can hopefully keep up with your oral hygiene and avoid complications.