Chemotherapy and radiation therapy help in treating cancer, but it can cause complications in your body.

These complications or side effects can delay or even stop your cancer treatment. Cancer patients receiving chemotherapy are at high risk of developing oral complications.

It is vital that cancer patients do not neglect their oral health. If you are receiving cancer treatment or are going to start in the future, you should have all the knowledge regarding chemotherapy and its side effects on your body.

In this article, we will strive to understand the side effects of chemotherapy on your mouth and how to manage it.

How does chemotherapy affect your mouth?

Chemotherapy and radiation therapy stop or slow the growth of fast cancer growing cells.

However, it also prevents the growth of normal cells in the lining of the mouth, which affects the ability of oral tissue to repair itself. (1)

Radiation therapy can directly affect the oral tissues by damaging salivary glands and jaw bone. Chemotherapy also upsets the natural balance between good and harmful bacteria inside your mouth.

These side effects can be excruciating and make it hard for you to eat, drink, swallow or even talk. You are more likely to get an oral infection while receiving cancer treatment, which can delay the chemotherapy. (2)

If the side effects become too severe, your oncologist may delay your cancer treatment or even stop it altogether.

How does a dentist help?

It is essential that you visit a dentist at least 2-4 weeks before starting chemotherapy or radiation therapy. The dentist performs a thorough oral exam, takes x-rays if necessary and treats any existing oral problems.

It has been observed that people with fewer dental problems before starting chemotherapy, show fewer and less severe oral side-effects. Visiting a dentist during your chemotherapy can help you manage any complications which have arisen due to the treatment.

Your dentist and oncologist need to work together to devise an optimal treatment plan for you. When you have fewer complications from the cancer treatment, it works better, and also you have a better quality of life. (3)

What are the oral side effects of different cancer treatments?

Chemotherapy affects your teeth, oral tissues, salivary glands, and jaw bone, directly or indirectly. Chemotherapy and radiation therapy kill fast-growing cancer cells, but it also affects the growth of healthy cells.

Some of the most common oral side effects of chemotherapy are listed below:

There are different cancer treatments according to your diagnosis, and it shows a different set of side effects with each:

 

 

 

 

Radiation therapy to the head and neck

o   Dry mouth

o   Decrease in saliva

o   Thickened saliva

o   Infections

o   Increased risk of tooth decay

o   Loss of taste

o   Mouth sores

o   Bone diseases

o   Stiffness in the jaw

 

 

Chemotherapy

o   Mouth sores

o   Pain in the mouth and gums

o   Peeling or burning of the tongue

o   Infections

o   Changes in taste

o   A temporary decline in immunity

 

 

Radiation given in Stem cell/ Bone marrow transplantation

o   Dry mouth

o   Decreased saliva

o   Mouth sores

o   Sensitivity to spicy or acidic foods

o   Difficulty in swallowing

o   Increased risk of tooth decay

Why are mouth sores common for cancer patients?

Mouth sores are ulcers that form in and around your mouth including your tongue, gums or lips. These ulcers are formed after chemotherapy or radiation therapy, because of the destruction of healthy cells, along with the cancer cells. (5)

Why is dry mouth common for cancer patients?

Chemotherapy affects the salivary flow by damaging the salivary glands. Also, the use of certain medications during chemotherapy decreases the amount of saliva in your mouth.

Dry mouth also increases the risk of tooth decay in cancer patients.

Why are sensitive gums and gum disease concern for a cancer patient?

As the chemotherapy destroys healthy cells alongside the cancer cells, it can result in minor tissue swelling and sensitivity in gums. You may notice tenderness, bleeding, inflammation or even loose teeth. (6)

As your body’s immunity is considerably weakened during chemotherapy, the bacteria from your mouth can quickly spread throughout the entire body. That is why it is essential to treat any existing gum diseases before you start chemotherapy.

Why are jaw and facial pain common for cancer patients?

Cancer patients often complain about pain in the face and jaw during and after chemotherapy. It is because radiation therapy causes inflammation and scarring of the facial muscles.

The stress of cancer treatment can cause the patient to grind their teeth, which can add to the facial and jaw pain.

Why are infections common in cancer patients?

Chemotherapy lowers the immunity of your body, which can worsen any existing infection and spread it through your body. It can also increase the risk of you contracting a new disease.

Chemotherapy also makes it difficult to fight these infections by slowing the healing process.

How to keep your mouth healthy during chemotherapy?

It is vital that you visit a dentist 2-4 weeks before the start of chemotherapy. The dentist can treat any existing infections and help you manage the side-effects after chemotherapy. The healthier your mouth is less will be the side effects after chemotherapy. (7)

The following tips and steps can help you manage the different oral side effects from chemotherapy:

To keep your mouth moist

  • Stay hydrated and drink lots of water.
  • Chew sugar-free gum or suck on sugarless candies to stimulate salivary flow.
  • Use a saliva substitute.
  • Avoid tobacco or any of its products.
  • Avoid alcohol consumption.
  • Use a humidifier at night.

To keep your teeth, gums, and tongue clean

  • Use an extra-soft toothbrush to brush twice a day and after every meal.
  • Floss your teeth gently every day. If your gums feel sore or bleed at any point, avoid those areas and floss rest of the teeth.
  • Use fluoride toothpaste.
  • Don’t use mouthwashes that contain alcohol.

If your mouth feels sore

  • Choose foods that are easy to chew and swallow
  • Take small bites of food and sip liquids during your meals.
  • Eat moist or softened foods, e.g., cereal, mashed potatoes, scrambled eggs, etc.
  • Avoid spicy, salty or acidic foods.
  • Stay away from sharp, crunchy foods that can cut or scrape your mouth.

Conclusion

While chemotherapy and radiation therapy help treat cancer, it can cause some unpleasant side effects all over your body, including your mouth.

These side effects can delay or even stop your cancer treatment and also affect the quality of life.

It is advisable to visit your dentist before starting your chemotherapy. Your dentist and oncologist will work together to provide the best palliative care you need during your treatment process.

Radiation therapy can directly affect the oral tissues. Chemotherapy upsets the natural balance between good & harmful oral bacteria.