Oral Care Basics During Cancer Treatment

Learn how to manage the oral side effects of cancer treatment

The Cells of the Human Body

The human body is a marvelous network made up of trillions of cells. New cells are made through a process called cell division where one cell becomes two, two cells become four, and so on. There are hundreds of types of cells in the human body: brain cells, muscle cells, skin cells, fat cells, and blood cells, just to name a few.

When cells divide, they make a copy of all their genes into the new cell; much like a photocopy. To ensure all the genes copied are identical, there are checkpoints to check the quality of the copy. If the checks fail, normal cells will stop dividing until the conditions preventing a perfect copy are corrected. However, abnormal (cancer) cells created due to heredity or environmental conditions do not always obey the rules of the checkpoints, so these cells can continue to grow and divide even if the copy is damaged.

Cancer occurs when damaged or abnormal cells grow and multiply uncontrollably, forming a lump (tumor). Sometimes these abnormal cells move to and grow in different parts of the body (metastasize). Some growths are not cancer; however, they don't invade nearby tissue or spread to other parts of the body and are called benign.

How Does Cancer Affect Oral Health?

Chemotherapy and radiation can weaken one's immune system leading to susceptibility to infection. Infection can delay cancer treatment. So it is important to maintain oral health with a good oral hygiene (brushing/flossing) routine before starting cancer treatment. According to the National Institute of Dental and Craniofacial Research, complications from cancer that affect the mouth include:

• Infection
• Mouth sores
• Jaw pain
• Sensitive gums
• Trouble eating

Oral complications resulting from the illness, treatment, or procedure may be mild or severe and may impact one's ability to eat (causing weight-loss) and impact day-to-day life. Be sure to discuss with your dentist and healthcare provider any oral complications that may be involved with the cancer or may result from cancer treatment.

What to Do During Cancer Treatment

It is vital to see your dentist before beginning cancer treatment so that your teeth, gums, and surrounding tissues can be monitored by your dentist. Continue to:

• Brush after every meal and before bed with a soft bristled toothbrush, replacing the toothbrush every 3-4 months, or as needed.
• Floss before bed with un-waxed dental floss. If flossing was not a part of your daily routine, discuss with the dentist first before starting this routine.
• Use a fluoride toothpaste.
• Talk to your dentist about the need for an oral rinse or oral irrigation.

How to Manage Symptoms in the Mouth during Cancer Treatment

The most common side effects during cancer treatment are:

• Dry mouth. Manage dry mouth by taking sips of water throughout the day, use a humidifier in the room, or chew sugar-free gum.
• Painful/sore areas in the mouth or throat. A prescription for a numbing agent may be provided.
• Difficulty with swallowing. Many with this condition may choke on their food or on liquid while eating. As a result, they may avoid eating, lose their appetite, or skip meals. The following are suggestions to help with swallowing:
  • Incorporate gravy into the meal.
  • Dip dry foods into soup, broth, or other liquids.
  • Puree the food.
  • Drink water, milk or juice with the meal ― avoiding alcohol.
  • Seek emergency care if you are having trouble with breathing, notice pale/bluish skin, or lose consciousness.
  • If you find you are choking and no one else is present to perform the Heimlich maneuver to assist you, try to dislodge the foreign object by coughing it out. If this doesn't work, perform the Heimlich Maneuver on yourself by:
    • Forming a fist with your strongest hand
    • Placing it just above your belly button
    • Holding the fist with your other hand
    • Driving the fist and hand in towards the diaphragm and up (repeat this move several times); and
    • If your force does not dislodge the object, add more force. You can add additional force with a stable object nearby that is about your waist high (chair, table, counter top or rail). Bend over on the object with your hands still in position and drive your body against the object.

Contact your dentist or doctor if you have a fever, new sore areas in the mouth and throat, or bleeding of your gums and mouth while brushing, flossing, or eating.

Things to Avoid During Cancer Treatment

If you are experiencing mouth pain during cancer treatment, avoid:

• Foods that are too spicy, salty, citrusy, hard, coarse, dry, cold, hot, or strong in spices
• Drugs that are not prescribed
• Over the counter drugs that are not recommended
• Alcohol and tobacco

Not following your dentist or doctor's order may impact the effectiveness of cancer treatment or worsen its side effects.