When cancer enters the body, it is there to fight. Not only is it a well-armed and very prepared opponent, it’s not likely to give up easily, even when treatment comes at it relentlessly.

The ultimate goal of cancer treatment is to slow the growth of, kill, and prevent new cancer cells from growing. In order to do this effectively, the medicine used must be very potent. Unfortunately, this means that life after cancer often comes with various short- and long-term side effects— one of which includes dental complications.

The following information is intended to be your guide so you can learn more about dental problems caused by cancer treatments— which treatments are most likely to be the culprit, why they cause oral health issues in the first place, the most common dental issues experienced by cancer survivors, and tips that will help you manage and prevent them. 

Cancer Treatments That Cause Dental Complications

While all types of cancer treatments come with their own list of side effects, dental problems are most likely to arise due to chemotherapy and radiation.

Oral health issues can arise both during and after treatment. Both chemo and radiation are designed to kill, slow, and stop the growth of fast-growing cancer cells. The downside is that neither treatment method is capable of differentiating between cancerous cells and the healthy cells. This means that your healthy, fast-growing cells can also be affected by your cancer treatment. 

The cells in the lining of your mouth happen to be normal, fast-growing cells, which can be damaged by both radiation and chemotherapy. Because of this, the tissues in the mouth are unable to repair themselves because they have lost the ability to regenerate new cells. Other dental issues that can arise due to radiation therapy include the breaking down of oral tissues, salivary glands, and even bone.  

It is important to note that dental issues resulting from chemotherapy tend to be shorter in duration than those resulting from radiation. It is also imperative to understand that radiation around the head and neck makes cancer survivors more prone to dental problems due to its close proximity to the mouth.

Preventing and Managing Dental Complications

While there is no guaranteed way to prevent the occurrence of dental problems due to cancer treatment, there are measures you can take to minimize and manage oral health issues. Dental health should be managed before, during, and after treatment for the desired results and to reduce complications. 

Before Cancer Treatment

The more proactive you are, the better. Prior to beginning cancer treatment, try to visit your dentist for a thorough dental and mouth check-up. Any issues found should be addressed before your cancer treatment begins. If you are diagnosed with a chronic issue, work with both your oncologist and dentist to create a plan for management during treatment. 

The benefits of preventive oral care should not be ignored. In addition to increasing the likelihood that your cancer treatment plan is successful, it also reduces the chances of oral health issues causing very serious health issues later on. 

During Cancer Treatment

Communicate regularly with your oncologist and dentist so they can carefully monitor the health of your mouth and immediately treat any issues that arise. The sooner oral health issues are caught, the more likely they’ll be able to work towards reducing discomfort and potential complications. 

Treating dental problems in a timely fashion may also increase the effectiveness of cancer treatment. Allowing dental problems to persist during treatment, means your body is working overtime, trying to fight not one but two enemies.

Here are some tips to help ease the symptoms of dental issues during cancer treatment.

Mouth Sores

Mouth sores are a common side effect of certain types of chemo and radiation. The symptoms can be eased by: 

• Using a gentle toothbrush and toothpaste
• Drinking liquids with a straw
• Thoroughly cleaning dentures 
• Keeping lips hydrated with the use of a soothing lip balm
• Eating cold foods or foods that are soft and bland
• Asking your oncologist about prescription medication to relieve the pain

Bleeding of the Mouth

Just as the name implies, bleeding of the mouth involves extremely painful sores or ulcers in the mouth that can lead to bleeding, an infection, not eating, inability to drink water, and refusal to take medications. Symptoms include red or swollen gums, blood in the mouth, bruises, increased mucus, white patches, and pink dots in the mouth. Consider these tips to ease the symptoms: 

• Use a soft-bristled toothbrush and a mild toothpaste
• Rinse your mouth with ice water every two hours and hold ice chips in your mouth
• Keep your lips hydrated with a mild lip balm
• Eat soft foods that will not irritate your gums

Dry Mouth and Thickening Saliva

Radiation, chemo, medications, and dehydration can all be causes of dry mouth or thickening saliva. When your salivary glands become irritated they produce either less saliva, thicker saliva, or both.

The severity of the condition varies among patients. Difficulty swallowing food, thickened saliva, food residue left in the mouth, and cracked lips and gums are some symptoms that may be experienced. This can lead to cavities and infections. Here's what you can do:

• Suck on ice chips
• Drink fluids with meals, chew slowly and take small bites
• Use lip balm to moisturize lips
• Rinse out mouth often with artificial saliva or doctor-approved solution
• Chew sugarless gum

After Cancer Treatment

It’s important to understand that the dental issues experienced vary among patients. Some survivors may experience minimal to no mouth issues at all while others experience severe and late-onset side effects.

Remain proactive even after treatment ends, especially since dental problems can present themselves down the road. Make sure that you are caring for your teeth properly, brushing and flossing as recommended by your dentist. Any issues you notice with your gums, teeth, or mouth should be brought to the attention of the dentist as soon as possible so the issue can be resolved.  

In addition to the most common dental problems that can occur during treatment, other oral issues that may be experienced by cancer survivors include tooth decay, gum disease, and changes in taste after cancer treatment.

Tooth Decay and Gum Disease

Tooth decay is a dental condition in which the enamel of your tooth is destroyed to the point where tiny holes (cavities) develop in your teeth. Gum disease is a condition in which the tissues that hold your teeth in place are affected. In order to prevent tooth decay and gum disease from affecting your teeth and gums any further, it is important to speak with your dentist as soon as possible. He or she can also come up with a solution to restore your mouth's health. 

Changes in Taste

A patient can experience changes in taste months after the end of chemotherapy. This side effect is a result of nausea, vomiting, and damage to the oral tissues. To help manage the changes in taste after cancer treatment, consider maintaining good oral hygiene, eating small meals more frequently, marinating meats, and flavoring foods with bold seasonings and spices. 

The bottom line is that understanding how your oral health may be affected by cancer treatment and taking the proper steps to manage it will lead to an improved quality of life. 

If you have any questions or concerns about dental issues before, during, or after your cancer treatments, we encourage you to consult with your dentist as well as someone from your Minnesota Oncology cancer care team.