Dental Care and Chemo
Chemotherapy is a systemic type of cancer treatment. That is, chemotherapy enters the body and treats the whole body. One of the side effects of chemotherapy is inflammation of the mouth lining (Mucositis), thus breaking the first barrier between organisms and the blood stream, as well as a reduction in blood counts, making a person more susceptible to infection. If a person has unhealthy teeth, an infection could arise and, during chemotherapy, spread due to the low blood counts. An infection in the bloodstream can make a person very ill and, may be, life threatening.
Good oral hygiene can eliminate the need for extensive dental work. During therapy, especially with extensive high dose chemotherapy, good oral hygiene will decrease the incidence of dental side effects. Similarly, ill-fitting prostheses, orthodontic appliances, defective restorations, and other sources of mucosal and gingival irritation have been associated with an increased risk of developing oral mucositis during chemo therapy.
Prior to starting chemotherapy
In addition to an inspection of the oral cavity, the pre-therapeutic work-up should include dental, periodontal and, if necessary, radiographic evaluation to identify caries, peri-apical, third molar, and periodontal pathology.
During chemotherapy
- Patients should be advised to perform frequent and effective mechanical plaque removal using a soft toothbrush and dental floss. To maintain oral moistness rinse with saline or bicarbonate solutions, use lip lubricants, and employ “sugarfree” products.
- It is also recommended that patients avoid factors that cause irritation, including hot, spicy, and coarse foods, fruits and beverages with a high acid content, and alcohol (including alcohol-containing elixirs). Patients should refrain from smoking.
- Patients should try to avoid dental cleanings and invasive dental procedures during chemotherapy due the risks for infection. If dental work is needed, your doctor may want to prescribe antibiotics prior to your procedure.
After Chemotherapy
Patients should wait about 4 weeks after chemotherapy before undergoing dental cleanings and invasive dental procedures.