Radiation Chemo And Dental Problems
Oral cancer patients arent the only ones susceptible to dental problems. One of the main issues is that chemo drugs slow the production of saliva, which contains enzymes that are vital to your oral health. If applied to the head or neck area, radiation can cause nerve damage to your teeth. Mouth sores from chemo are common, as are the following symptoms:
- Burning, peeling and swelling of the tongue
- Change in taste
However, with some preventative care and the guidance of a professional dentist, most of these side effects are avoidable.
A Special Note For Parents Of Children With Cancer
All patients undergoing cancer treatment should pay special attention to their oral health to reduce the risk of serious problems.
In children with cancer, however, the need for good dental care is even higher, especially for children under the age of nine. This is because children under nine are at risk of abnormal tooth and jaw development.
Your childs dentist may want to extract loose primary teeth before cancer treatment. This can help protect permanent adult teeth.
Children with cancer need a dentist who understands their specialized needs.
Please Keep Your Dental Team Informed About Your Treatment
If you are being treated for breast cancer, it is essential that you inform your dentist. This is because there are many medications used in the treatment of this disease which may impact both on your oral health and the dental treatments that may be required.
For example, the use of chemotherapeutic drugs may affect the rate of healing following a surgical procedure. Most patients receive chemotherapy or radiation therapy however, some patients use bisphosphonates such as Fosamax, Actonel, Prolia, and others. The reason that some women take medication such as this is because breast cancer treatments can cause bone osteoporosis. Bisphosphonates actually assist with maintaining bone strength and help with osteoporosis.
Unfortunately, this important treatment doesnt come without risks. Recent studies from the University of Southern California suggest long-term use of bisphosphonates may cause destruction of the jaw bone. This condition is called BRONJ Bisphosphonate-Related OsteoNecrosis of the Jaw. Essentially, the bone loses its ability to heal properly. A wound in the bone may not heal completely. Infection or necrosis may follow. While the risk of this is low, it can increase with chemotherapy.
Therefore, dental treatments and procedures that require bone healing should precede intravenous bisphosphonate therapy. Patients should understand the importance of maintaining good oral hygiene and having regular dental assessments. You can read more about this here.
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Mouth Care After Cancer Treatment:
After chemotherapy is completed most people can return to their regular dental care routine — brushing, flossing and seeing a dentist at regular intervals for cleaning.
For those who have had radiation therapy to the head and neck, added precautions after treatment should include:
- See a dentist every 4-8 weeks for the first 6 months
- Continue to maintain good oral care- brushing, flossing and rinsing several times a day
This follow up with a dentist after completing treatment is especially important because radiation therapy can cause dry mouth, an increase in dental caries , and changes in the muscles and bones that open and close the mouth.
Good oral hygiene habits before during and after treatment for cancer can help you avoid serious problems and infection. And because side effects from cancer treatment can vary greatly from person to person, its important to talk to your doctor and nurse about what side effects to expect, how long they will last, and when to notify the doctor about a troublesome symptom.
How Severely Does Chemotherapy Affect Teeth
Side effects of chemotherapy can vary in severity. Sometimes they are annoying and will go away shortly after finishing chemo. However, if side effects aren’t treated, they can lead to infection. During cancer treatment, your body cannot fight off infection, so infections can be even more severe and delay your cancer treatment.
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Dental Care For Cancer Patients: Before During And After Chemo Or Radiation
Great strides have been made in the field of cancer treatment, but many of the drugs and procedures used to kill cancer cells have a myriad of side effects on the body. Chemotherapy and radiotherapy damage healthy cells as well, which can leave your teeth vulnerable to infection. If you are newly diagnosed with any form of cancer and will be seeking treatment, you should establish a relationship with a dentist who has experience in providing dental care for cancer patients as soon as possible. This guide will explain dental care before, during and after cancer treatments.
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The Following Recommendations Are Important To Follow:
- Brush with a soft toothbrush or sponge brush to clean your teeth and gums.
- Only use alcohol-free mouthwash, preferably one free of saccharin, but one containing xylitol.
- When white blood cells counts are reported by your physician to be low, avoid dental treatment.
- Avoid dental treatment for about a week after chemotherapy.
- Inflammation starts with red gums that may bleed. Even slight bleeding should not be ignored.
- Use toothpaste and chewing gum with xylitol.
- Regular dental visits to identify problems before they develop.
- If you wear dentures, make sure you keep them clean and that they fit well. Make sure to take them out at night.
To our patients, friends, and families, this month we honor and remember those who have lost their battle, are currently fighting and who have survived. Please remember to schedule your mammogram and to perform routine self exams. If you or someone you know will be receiving treatment for cancer, please contact our office to schedule a consultation prior to and after your treatment. We have assisted several of our patients through this difficult and honestly scary time in their life and having the expertise to handle these very sensitive life situations. We are truly committed to your comfort.
Mai-Ly Ramirez, DDS, Dan Gustavson, DDS & Your Fountains Dental Excellence Team
Cancer Treatment And Oral Health
Dental care is an important element of cancer treatment. As soon as possible after a diagnosis of cancer is made, your treatment team should involve your smile.com.au dentist. If you will undergo treatment, you should do the following:
- Schedule a dental examination and cleaning before cancer treatment begins and periodically during the course of treatment
- Inform a smile.com.au general and cosmetic dentist that you will be treated for cancer
- Discuss dental procedures such as extractions or insertion of dental implants with your oncologist before starting the cancer treatment
- Ask your smile.com.au dentist to check and adjust removable dentures as needed
- Inform your smile.com.au dentist and physician about any bleeding of the gums, pain or unusual feeling in the teeth or gums, or any dental infections
- Update your medical record with your smile.com.au dentist to include the cancer diagnosis and treatments
- Provide your smile.com.au dentist and oncologist with each other’s name and telephone number
- Maintain excellent oral hygiene to reduce the risk of infection
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Managing And Treating Dental Or Oral Side Effects
If you have any dental or oral side effects during treatment, let your health care team know right away. Relieving side effects is an important part of cancer care and treatment. This is called palliative care or supportive care.
The specific treatment your doctor recommends will depend on your symptoms. There are several common treatments for dental and oral side effects:
Mouth rinses that contain salt and baking soda may help treat mouth sores. However, if you are taking high blood pressure medication, you may need to avoid mouth rinses with salt. There are also a variety of prescription rinses that may soothe sore spots.
Pain medications may also be used to treat pain from mouth sores. Medications may be placed directly on the sores, taken by mouth, or given through an IV.
Antibiotics, antiviral drugs, and/or antifungal drugs are used to treat infections.
Drinking water and sugarless drinks may help manage dry mouth. Sucking on ice chips or having sugar-free chewing gum with xylitol may also help. Avoid things that will dry out the mouth, such as soda, fruit juice, cigarettes, chewing tobacco, and alcohol.
Medications that make saliva may help some people prevent or lessen dry mouth. Topical oral gels or other medications may help dry mouth caused by radiation therapy to the head and neck.
Cancer Chemotherapy And Oral Care
Hundreds of thousands of patients receive cancer chemotherapy annually in the United States. All dental practices, including pediatric and orthodontic practices, have patients who have undergone, are undergoing, or will undergo cancer chemotherapy in the future. Cancer chemotherapy is changing rapidly, as established protocols evolve and are refined and new therapeutic approaches are introduced. This article discusses current concepts in medical oncology and cancer chemotherapy as they relate to oral healthcare.
Dental care is an important consideration for cancer chemotherapy patients for several reasons: Chemotherapy patients who have excellent oral health are less likely to have severe complications from their cancer treatment than are patients in poor oral health Dental treatment before, during, and after cancer chemotherapy requires special considerations and Chemotherapeutic agents and coagents are associated with specific oral pathology.
Included among the current issues regarding oral manifestations of cancer chemotherapy are a possible relationship between the osteoclast inhibitors pamidronate and zoledronate and osseous necrosis of the jaws1 caution with regard to the daily use of chlorhexidine2 and the question of bacterial endocarditis prophylaxis for patients who have previously received cardiotoxic chemotherapy and/or left chest wall radiation therapy.3
BONE MARROW TRANSPLANTATION
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Chemotherapy: Oral Side Effects And Dental Interventions
Athanasios Poulopoulos Petros Papadopoulos Dimitrios Andreadis
Department of Oral Medicine and Oral Pathology, Dental School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
Correspondence Address: Dr. Dimitrios Andreadis, Department of Oral Medicine and Oral Pathology, School of Dentistry, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece. E-mail: email@example.com
Dr. Dimitrios Andreadis is an Assistant Professor of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, Greece. His current clinical/research interests include Diagnosis of Oral Diseases, HPV in Oral Diseases, Oral Cancer, Mucocutaneous Diseases, and Salivary/Oral Stem Cell Biology in co-operation with Laboratory of Molecular Biology, Department of Conservative Dentistry, Periodontology/Preventive Dentistry, Medical University of Hannover, Germany. He is a member of European Association of Oral Medicine, International Association of Oral Pathology and International Association for Dental Research. He participated in more than 50 published manuscripts, more than 100 presentations and serves as invited reviewer in more than 15 journals.
Dental Care For Cancer Patients Undergoing Treatment
At Metropolitan Dental Care, our team understands that a cancer diagnosis feels overwhelming. Were here to help you navigate the waters by listening to your concerns, answering questions, and providing guidance on how to best handle dental care while undergoing cancer treatment. Our Denver dentists are sensitive to your needs and feelings, and we are here for you.
The most common cancer treatments are chemotherapy and radiation . With these treatments, side effects are to be expected, though you may not be familiar with the effects cancer treatment can have on oral health.
For instance, the toxicity of chemotherapy that causes hair loss also affects the rapidly growing cells in the mouth. This causes damage to the mucous membranes and gum tissue. Mouth sores are very common.
We will explain and answer all of your questions about dental care for cancer patients. Please know that you can call our office any time for specific information or to schedule an appointment.
Poor oral health, as well as dry mouth syndrome, can also compromise your immune system. This could be detrimental for patients already experiencing a weakened immune system due to cancer treatment. So, diligent oral care during chemotherapy and/or radiation is very important.
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Causes Of Dental Or Oral Side Effects
Not all cancer treatments affect the mouth, teeth, and jaw. But the following treatments may cause specific dental and oral side effects. To learn more about your risk of experiencing these side effects, talk with your health care team.
Radiation therapy to the head and neck. Side effects of radiation therapy to the head and neck may be temporary or continue for several years after treatment. They can include:
Stiffness in the jaw
Higher risk of tooth decay and gum disease
Radiation therapy can change the amount and consistency of your saliva. This increases your risk of tooth decay and gum disease. Having good oral hygiene is important in lowering your risk of these conditions. Your dentist may also recommend special fluoride treatments during and after radiation therapy. This treatment, along with a low-sugar diet, can help protect your teeth. Your doctor or dentist may also recommend exercises to prevent stiffness in the jaw.
Learn more about the side effects of radiation therapy.
Chemotherapy. Dental and oral side effects from chemotherapy usually go away soon after treatment ends. They include:
Learn more about the side effects of chemotherapy.
Bone marrow/stem cell transplantation. The high-dose chemotherapy that is usually given before a bone marrow or stem cell transplant may cause dental and oral side effects. These are similar to those described under chemotherapy above.
Learn more about the side effects of bone marrow transplantation.
Chemotherapy Resources And Support
Receiving a cancer diagnosis and undergoing chemotherapy can definitely take a physical, emotional, and mental toll. However, there are many resources available to help you get the support you need.
For example, it may be helpful to speak with and learn from others who are on a similar journey as you. You can do this through joining an in-person or online support group.
If youre not quite ready to engage with a support group, one-on-one counseling may be a good option. Try to find a mental health professional who specializes in counseling people with cancer.
Some support resources to get started with include:
- Medical care team. If you have a medical care team, ask them for recommendations on support services. There may even be support groups or counselors that are associated with your treatment center.
- American Cancer Society. The
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Contact With Body Fluids After Treatment
Your body typically breaks down and passes chemotherapy drugs during the 48 to 72 hours after your treatment. Because of this, its possible for these drugs to be present in various body fluids, including urine, stool, and vomit during this time.
Because chemotherapy drugs can affect healthy cells, coming into contact with them in various body fluids can be potentially harmful to yourself or others. Thats why its a good idea to avoid contact with body fluids that may contain them.
Here are a few tips for a avoiding contact:
- Wash your hands. Thoroughly wash and dry your hands after using the bathroom or after coming into contact with any body fluids that may contain chemotherapy drugs.
- Flush twice. Flush the toilet twice after using the bathroom, and make sure that the lid is down to prevent splashing.
- Wash soiled fabrics. Promptly wash any clothes or sheets that have had contact with body fluids. Wash them separately from other laundry, and use the warm setting on your washing machine and normal laundry detergent.
- Clean after youve been sick. If you vomit, clean any containers or soiled areas with warm, soapy water and dry thoroughly.
Your doctor will know which bodily fluids may be affected by chemotherapy drugs. Be sure to ask so that you can take appropriate precautions.
Why Is The Dentist Important
Here are four reasons why cancer care should begin with an early visit to the dentist:
1) Some cancer treatments may increase your vulnerability to infections by lowering your white blood cell count. Before chemotherapy begins, have your dentist check to see if you have a gum infection, cavities that need filling, ill-fitting dentures or mouth sores. Addressing these issues well before treatment begins may help you avoid further complications later. Communication between the dentist and the oncologist is helpful, Dr. Crilley says.
2) Radiation therapy to the head or neck may affect your dental health. The treatments may reduce the calcium in tooth enamel, which may cause cavities or the kind of salivary gland damage that leads to dry mouth. Your dentist may recommend a fluoride gel or rinse to help harden the enamel, along with techniques for keeping the mouth moist. Other supportive care therapies, including acupuncture, may also help. If teeth need to be extracted, you should consider seeing an oral surgeon or dentist with radiation experience, as the jaw becomes more brittle after radiation, adds Dr. Bradley Mons, Head and Neck Surgeon at our Tulsa hospital.
4) Ask your dentist for tips to keep your mouth as healthy as possible during cancer treatment. These may include:
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Engage In A Calming Activity
Its possible that you may experience many different feelings during chemotherapy, such as anxiety, sadness, or anger. Doing a calming activity may help you to cope with these feelings when they occur. Some examples include:
- taking part in a hobby that you enjoy
- visiting with family and friends
- trying out meditation or breathing exercises
Oral Health Side Effects Of Cancer Treatment
Chemotherapy and radiation can both have a toxic effect on the soft tissue inside your mouth. They also interfere with your bodys natural ability to heal.
Patients undergoing chemotherapy experience suppressed white blood cells, red blood cells, and platelets, which greatly increases the risk of infection. It can also debilitate bone marrow function.
In addition, if you have head and neck cancer, you will have an even higher chance of oral health problems. This again underscores the need for good dental care for cancer patients.
Cancer treatment can cause these mouth problems:
- Damage to mucous membranes lining the inside of the mouth
- Painful mouth sores
- Tongue swelling and a burning sensation
- Increased risk of infection
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