New research from a recent surgeon general’s report shows the prevalence of oral complications from cancer treatments. Patients who receive dental care before getting cancer treatment may reduce the risk of complications. This care includes managing pre-existing dental conditions in preparation for cancer treatment, supportive dental treatment to prevent and manage oral complications, and maintain oral health after cancer treatment and managing any long-term complications.
Encourage patients to brush after every meal and before bed, floss daily, use a baking soda rinse several times a day, perform jaw exercises and avoid sugary foods or items with high acid content or spicy substances. It is also important to avoid alcohol and tobacco use, as it can irritate tissue and slow recovery time and increase the risk of developing a second cancer.
When providing dental treatment to patients currently undergoing cancer therapy, look for soft tissue inflammation and signs of infection, dry lips and problems with jaw movement and saliva glands. Don’t perform any elective oral surgical procedures during radiation treatment and make sure you have the most recent blood work to confirm appropriate platelet count, clotting factors, and absolute neutrophil count. Consult with the patient’s oncologist to confirm patient safety for the planned treatment.
Oral mucositis is a common side effect of radiation and chemotherapy cancer therapy. This occurs when there is tissue swelling in the mouth and inflammation and ulceration in the mucous lining of the gastrointestinal tract. This can lead to inability to eat and predisposition to infection. In most cases, oral mucositis is self-healing and resolves in two to four weeks if there is no infection. Oral hygiene and regular preventive oral care are essential. Encourage patients to continue hygiene and self-care when able.
Keep in mind that patients exposed to high-dose radiation are at chronic risk of dry mouth, tooth decay and osteonecrosis. Be on the lookout for the reappearance of tumors in patients with cancers in the oral cavity and head and neck area. Because oral cancer screenings are part of comprehensive oral evaluations, dental providers are most likely to identify lesions. Early diagnosis of cancer improves survival rates. Make it a point to do a thorough examination at each appointment.
Sources:
“Oral Health in America: Advances and Challenges.” nidcr.nih.gov, National Institute of Dental and Craniofacial Health, December, 2021.
“Oral Complications of Chemotherapy and Head/Neck Radiation.” cancer.gov, National Cancer Institute, 26 April, 2019.
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