Chemotherapy and Your Mouth

Oral and dental side effects of chemotherapy aren't the first ones that come to mind, but they are common. The cells lining the oral cavity are fast-growing and can be damaged by chemotherapy. Drugs used in chemotherapy work by killing rapidly-growing cells. Cancer cells are typically the fastest growing cells in the body and they are the intended target. Unfortunately, chemotherapy also may attack healthy cells which normally also grow quickly, including those in your mouth.

• mouth sores
• infections
• dry mouth
• bleeding of the gums and lining of the mouth
• general soreness and pain of the mouth

Infection is one of the greatest concerns when being treated with chemotherapy. It is much harder to fight an infection during chemotherapy because the immune system is not as strong. Serious infections can lead to your doctor delaying chemotherapy treatment or lowering the dosages of your treatment.

Eating and swallowing also may become difficult, possibly causing nutritional deficiencies. Foods may taste different because of effects on the tongue and taste buds from chemotherapy.

Prevention of oral problems during chemotherapy begins before treatment even starts. Your doctor may suggest you see a dentist and dental hygienist a few weeks before chemotherapy. He or she may refer you to a dentist that specializes in caring for patients undergoing chemotherapy.

At the dental visit, you can expect:

• a thorough exam of your mouth and gums
• dental x-rays
• cleaning by a dental hygienist
• instructions on how to care for your mouth and teeth
• dental work to fix any cavities or other dental problems

If you wear dentures, it is important that they fit well during chemotherapy. Talk to your dentist to get this addressed if it is a problem.

• During chemotherapy, follow your dentist's instructions for caring for your mouth. Your oncologist may prescribe a special mouthwash that will help prevent mouth sores that could lead to infection.
• Avoid food with sharp edges, like tortilla chips, that could possibly scratch or cut the gums or inner lining of the mouth. You may also want to cut out spicy or acidic foods and drinks because they can cause mouth irritation. Alcoholic beverages and tobacco products should be avoided as well.
• Avoid using toothpicks while on chemotherapy as they can cut your mouth.
• Maintain normal oral hygiene like brushing at least twice a day and flossing gently every day. Brushing with a soft head toothbrush may prevent unnecessary irritation and bleeding by the gums. Avoid any bleeding or sore areas while flossing. Mouthwashes can be used, but do not use a type that contains alcohol.
• Experts recommend sipping water, eating ice chips and keeping the mouth moist. Chewing sugarless gum and candies can help prevent dryness and irritation.
• If you experience any oral problems during treatment, let your doctor know. Medication can be prescribed to reduce pain, plus your doctor will want to monitor any side effects closely.

Oral problems usually go away after treatment ends. However, some people continue to experience oral problems following chemotherapy. Make sure your doctor and dentist are aware of any persistent side effects.