Cancer Treatment and Your Dental Health

October is National Breast Cancer Awareness Month. While this serves as a reminder to schedule your mammograms it is also important to remember your dental health. Breast cancer survivors and especially chemotherapy patients need to be aware that they are at a greater risk of tooth decay and other dental problems. 

There are connections between breast cancer and oral health. Chemotherapy and radiation may be used to kill or slow breast cancer cells by interfering with growth and multiplication of cells. 

If chemotherapy or radiation is prescribed as part of a treatment for breast cancer, side effects can be severe and include:

• Mucositis, a severe form of inflammation of the mouth.
• Increase risk of infection in the mouth. If the drug suppresses white cells, which normally protect against infection, deep cleanings and other invasive procedures such as tooth extraction can result in infection.
• Difficulty in swallowing.
• Taste alterations ranging from unpleasant to tasteless.
• Due to dry mouth, difficulty with speech and eating.
• Oral yeast infection from the fungus candida.
• Poor nutrition due to difficulties in eating, dry mouth or loss of taste.
• Deep aching and burning pain that mimics toothache.

Most patients are treated with chemotherapy or radiation. However, some patients may be treated with bisphosphonates, such as Fosamax, Boniva, and others. Recent studies from University of Southern California suggest long-term use of such bisphosphonates may develop into destruction of the jaw bone. The risk is low but increases with chemotherapy.

How to Minimize Side Effects

Most people are aware of hair loss with chemotherapy. But most don’t realize that more than one-third of people being treated for breast cancer can develop complications that affect the mouth. These complications can affect your quality of life. Preexisting or untreated oral disease can even complicate cancer treatment. This is one reason to make sure you visit your dentist at least one month before beginning cancer treatment.

The mouth is made of cells that renew themselves daily. Since chemotherapy and radiation target certain types of cells that regenerate quickly even under normal circumstances, your mouth will be susceptible to damage. If you minimize bacterial plaque buildup by practicing good hygiene, you can decrease the side effects of treatment for breast cancer. 

The following recommendations are important to follow:

• Brush with a soft toothbrush or sponge brush to clean your teeth and gums.  
  
• Floss gently.
• Only use alcohol-free mouthwash, preferably one free of saccharin, but one containing xylitol.
• When white blood cells counts are reported by your physician to be low, avoid dental treatment.
• Avoid dental treatment for about a week after chemotherapy.
• Inflammation starts with red gums that may bleed. Even slight bleeding should not be ignored.
• Use toothpaste and chewing gum with xylitol.
• Regular dental visits to identify problems before they develop.
• If you wear dentures, make sure you keep them clean and that they fit well. Make sure to take them out at night.

To our patients, friends, and families, this month we honor and remember those who have lost their battle, are currently fighting and who have survived. Please remember to schedule your mammogram and to perform routine self exams. 

If you or someone you know will be receiving treatment for cancer, please contact our office to schedule a consultation prior to and after your treatment. We have assisted several of our patients through this difficult and honestly scary time in their life and having the expertise to handle these very sensitive life situations.

Dan Gustavson, DDS & Your Auburn Dental Aesthetic Team