Chemotherapy can Wreak Havoc in the Mouth

A diagnosis of cancer is truly devastating to most people. Sadly, the chance of getting most forms of cancer increases, as we grow older. In fact, cancer is the second most common cause of death among senior citizens, those over 65 years of age. Treatment for cancer usually involves chemotherapy (drug therapy), radiation, surgery, or some combination of each. I will address some of the side effects from chemotherapy and the many problems it causes for the patient’s general and oral health.

Cancer is an uncontrollable growth of cells that can damage the body by destroying healthy tissue it comes into contact with, or by spreading throughout the body. Chemotherapy fights cancer by killing it’s rapidly dividing cells. Unfortunately, other cells in our body that rapidly divide are effected as well. Cells that stop bleeding called platelets, white blood cells that fight infection, and the inside lining of our cheeks are a few of the healthy cells in our bodies that are harmed by chemotherapy. A patient taking chemotherapy needs to be monitored very closely when coming for dental treatment. If the platelets are too low, the dentist may have difficulty stopping bleeding after dental extractions, cleaning under the gums, or other minor dental surgical procedures. If the amount of white blood cells is low, the patient will probably require antibiotics prior to dental treatment. Patients with very few white blood cells may need to be treated in a hospital for treatment of a dental infection.

Cancer patients being treated with chemotherapy will often develop cold sores and fever blisters in and around the mouth, be susceptible to thrush (a patchy white fungal infection of the mouth), gingivitis (an inflammation of the gums), and ulcerations inside the cheeks. To treat thrush, you dentist or oncologist (cancer doctor) can prescribe nystatin or clotrimazole, both potent antifungal medications. Mild soreness in the mouth can be eased with a mixture of two teaspoons of baking soda and one quart of water every two hours or allowing ice chips to melt in the mouth. More severe discomfort can be relieved with a combination of Benadryl, Maalox and Dyclone prescribed by your dentist or oncologist. I also recommend that all chemotherapy patients use a prescription antibiotic mouthwash, Peridex. Chemotherapy patients should brush three times a day with a very soft toothbrush, floss, and rinse with ½ ounce of Peridex after breakfast and before bed.

Nutrition is extremely important when fighting cancer. Soreness in the mouth can make eating difficult. The cancer patient may need to consider using dietary supplements such as Carnation Instant Breakfast or Ensure. Food may need to be softened in a blender to facilitate eating. Patients receiving chemotherapy need to make sure that their dentist has experience with cancer patients and keeps in close contact with the oncologist to ensure safe and effective dental treatment.