Chemotherapy and Radiation Therapy... How the mouth can be affected

By: Dr. Marc Lazare, DDS

Side effects in the mouth from chemotherapy or from radiation to the head and neck can be very serious, as these therapies not only kill cancer cells, but may also harm normal cells, including those in your mouth. Complications common to both types of therapy include: Painful mouth and gums, ulcerations, rampant decay, dry mouth, burning sensations in your tongue, change in taste, and difficulty eating, talking and swallowing. Suffering individuals are also more likely to develop infections, which can delay or force the cessation of cancer treatment.

The most important piece of advice that you could recommend to any person diagnosed with cancer is to visit their dentist at least 2 weeks before starting their chemotherapy or radiation therapy. The dentist will perform a complete exam, take all necessary films and address all mouth problems before they can become a possible source of infection or decay. Fluoride rinses are not enough to prevent tooth decay. Instead, a fluoride gel placed inside a custom-made mouth tray is recommended. Individuals who develop dry mouth are more prone to tooth decay due to the decreased levels of saliva that they can produce.

In order to minimize the harmful effects of dry mouth, one should avoid sugary substances such as candy or soda (unless sugar-free), chew on ice chips, sip water frequently, suck on sugar-free candy, or chew sugar-free gum to stimulate salivary flow.

Many times, as a result of cancer therapy, people develop jaw stiffness and a limited opening of their mouth. To prevent this, exercise the jaw muscles 3 times a day by opening and closing the mouth as far as possible (without causing pain) 20 times. Results are best after using warm moist compresses or by performing the exercises in a warm to hot shower. Other beneficial recommendations include brushing the teeth, gums and tongue gently, using an extra-soft toothbrush that had its bristles softened in warm water. Floss gently everyday, but stay clear of those areas that are sore or bleeding.

Avoid using toothpicks, tobacco products and alcohol. Stay away from hard, crunchy or spicy foods that can irritate your mouth. Avoid alcohol containing mouth rinses, but rather use a baking soda and salt solution (1/4 teaspoon of baking soda, 1/8 teaspoon salt in 1 cup warm water) followed by a plain water rinse. Remember, don't delay, even if cancer therapy has started, make sure that the oncologist works in a team approach with the dentist.