Our dental experts have put together this simple guide to help prevent problems and help you care for your oral health during cancer treatment.

COMMON ORAL COMPLICATIONS DURING CANCER TREATMENT

• Infections or inflammation in the mouth
• Taste changes
• Dry mouth aka xerostomia
• Tooth decay
• Bleeding gums and gum disease
• Changes in dental growth and development in children
• Breakdown of bone and tissue in area of radiation
• Discomfort or pain
• Malnutrition due to the loss of appetite or difficulty in eating
• Swelling, burning or peeling of tongue
• Dehydration

CAUSES OF DENTAL PROBLEMS DURING CANCER TREATMENT

There are several causes of potential mouth problems during cancer treatment.

• Chemotherapy and radiation can reduce your body’s ability to repair and fight infection.
• Radiation of the neck or head can directly damage oral tissue, salivary glands or bone.
• Pain relief and many other medications can cause dry mouth (xerostomia) or mouth ulcers.
• Underlying dental problems can flare-up.
• Chemotherapy, radiation and some medications can upset the healthy balance of bacteria in your mouth.

An effective oral care routine can help you prevent or manage these problems.

PREVENTING ORAL ISSUES

• Visit your dentist for a thorough check-up (including X-rays) before your treatment starts – one month before, if time allows, which enables them to detect and treat any underlying decay or infection. Ideally, there should be at least two weeks between dental surgery and starting treatment.
• It’s a very good idea to see the oral hygienist for a professional clean and polish after diagnosis, to remove plaque and tartar build-up and your mouth is in tip-top shape at the beginning.
• If you wear dentures, check their fit to ensure they aren’t irritating the mouth.
• If you have orthodontic braces ask your orthodontist if you should remove them for the duration of treatment.
• Diet plays a role. Avoid alcohol and caffeinated drinks, or very salty, spicy, cold, acidic or rough foods that may irritate or dry out your mouth. Oral bacteria thrive on sugar, so reduce it as much as possible and have a nutritious, healthy diet with plenty of calcium and Vitamin D.
• If you experience nausea and vomiting, don’t brush your teeth immediately afterwards as stomach acid demineralises enamel and weakens your teeth. Simply rinse your mouth with water or an alcohol-free mouthwash like Dentyl Dual Action, then wait an hour or so before brushing.

YOUR IDEAL DAILY ORAL CARE ROUTINE

A few mild adjustments to your daily oral care routine can make it easier and more effective during your treatment.

• Brush correctly at least twice a day for a full two minutes each time, right up to the gum line. Use a soft brush that will be gentler and cleans more effectively. Dip the brush in warm water before brushing to soften the bristles.
• Strong kinds of toothpaste may irritate the gums. Rather use mild toothpaste or for an ultra-natural option try Olgani Naturals paste or toothpowders.
• Clean in-between the teeth daily. If you find floss too firm, try an interdental brush or Sunstar GUM Soft-Picks. Not sure which to use? Ask your oral hygienist, they would love to get you cleaning in-between the teeth and can advise which tools to use.
• After eating or vomiting, rinse with an alcohol-free mouthwash like Dentyl Dual Action, Thryve or Olgani as alcohol will dry out already sensitive oral tissues.

You may well feel extremely tired during treatment, try not to let that negatively impact your oral care routine. A quality electric toothbrush or Sunstar GUM Daily Toothbrushes will give a ‘supreme clean’ with minimum effort.

DRY MOUTH

More than 400 commonly prescribed medications list dry mouth or xerostomia as a potential side-effect, including many chemotherapy drugs. There’s a strong chance you may experience reduced saliva flow at some point during your treatment. A dry mouth can make it difficult to swallow and even talk. Because saliva is the body’s way of keeping the mouth clean, plaque and bacteria build up more quickly, and you are at higher risk of bleeding gums, bad breath and dental decay. Rehydrating the mouth is the number one priority. Drinking water will give temporary relief and chewing gum can stimulate saliva flow. Some medications help produce saliva and products like Sunstar GUM Hydral have been designed specifically to moisturise and lubricate oral tissues.

MOUTH ULCERS

Mouth ulcers and sores are very common during cancer treatment.  They can be painful because they expose sensitive nerve endings which can make drinking, eating, talking and even cleaning your mouth uncomfortable. Whilst you might be tempted to not clean your mouth when it’s sore, an effective oral hygiene routine will help prevent further infection and can speed up healing. To learn easy ways to manage mouth ulcers read this article. For fast, effective relief try Aloclair gel or spray.

CRACKED LIPS

You may find your lips become dry and cracked during cancer treatment.

USEFUL LINKS

While cancer treatment can affect your mouth, a few simple tweaks to your oral care routine can help you prevent and manage many common oral problems. Your dental professional is also available to support you at this time. If at all possible see your dentist before beginning treatment and let them know if you experience any problems during your road to recovery. For further advice we’ve put together a useful Cancer and Oral Care booklet LOVE YOUR LIFE, LOVE YOUR ORAL CARE – download free here. The Cancer Association of South Africa website has excellent resources and the Look Good, Feel Better programme is focused on helping you look and feel your best during treatment.