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Cancer and Your Mouth: How can your Dentist help?

Being diagnosed with cancer of any kind is, without a doubt, life-changing. It is not only life-changing for the patient but for the family of a cancer patient as well. The focus immediately becomes on treatment. In many cases, the side effects of this treatment can be overlooked.  For that reason, we’re here to lend a helping hand and answer some commonly asked questions regarding your oral health and the side effects of common cancer treatments. Some commonly asked questions of dentists for cancer patients are:

  • What is mucositis?
  • What is burning mouth syndrome?
  • What is dry mouth and thrush?
  • What does it mean if I have a metallic taste in my mouth?
  • Why do we get ulcers in our mouth? 
  • What is the most common reason for mouth ulcers?

Many people don’t realize that cancer treatment(s), in many cases, will affect the mouth. For this reason, it’s vital that your dentist be part of your team of healthcare providers helping you before, during, and beyond cancer treatments. 

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I have cancer. Can I see my dentist? How often should I go?

After being diagnosed, patients are typically overwhelmed with the number of appointments made and the next steps of treatment that visiting the dentist can often be forgotten. It is important to visit the dentist for regular check-ups once you are diagnosed, during treatment, and beyond. 

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Why does cancer treatment affect the mouth?

Cancer treatments like chemotherapy and radiation and destroy rapidly growing cells. One of the areas with the most rapidly growing cells is in our mouth. Because the mouth also is home to many different types of bacteria, it is also a common area for potential infections to start when patients are undergoing cancer treatments. 

Before treatment

If at all possible, it is most ideal to visit your dentist before beginning cancer treatments, especially if your cancer involves radiation to the head or neck. We as healthcare professionals, want to ensure there are no oral health concerns that need to be addressed, as well as discuss methods to help prevent problems in the future. It is also a great time to discuss potential side effects of medications so you can have all the tools you need if adverse side effects do become an issue during or after cancer treatment. 

Your dentist can evaluate to see if there are any sources of potential irritation that need to be altered, such as ill-fitting dentures, partial dentures, or other oral appliances. 

Discussing and learning techniques to fine-tune your oral hygiene can help prevent extensive dental decay after treatment and help prevent infections. 

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What oral problems should I expect during cancer treatments?

Every patient’s experience with cancer will widely differ. There are many types of chemotherapy treatments, radiation treatments, and medications that all have different side effects in different people. Some common oral concerns from patients going through treatment are mouth sores, dry mouth, and altered taste. 

Advice for cancer patients with a dry mouth or mouth sores…

  • Let your dentist know right away if you are experiencing any mouth sores or dry mouth; a dentist or dental oncologist can often prescribe a topical medication to help with these issues.
  • Meticulous oral hygiene will be very important to help prevent any mouth sores from becoming infected if mouth sores do occur.
  • Use an extra-soft toothbrush and warm the bristles to help soften even more. 
  • Avoid rough-textured foods. 
  • Your dentist will discuss fluoride treatments to help prevent decay that can happen quickly as a result of dry mouth. 
  • Avoid mouthwashes that contain alcohol.
  • Avoid spicy foods.
  • If you experience dry mouth, sip water frequently, suck on ice chips, or sugar-free candy, use a saliva substitute to aid in keeping the mouth moist. 
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What Is a Dental Oncologist? 

Are there really dentists for cancer patients? How does the dental treatment for cancer patients differ?

Some cancer teams will include a Dental Oncologist. Dental oncologists are specially trained dentists for cancer patients, that train alongside general dentists. The most significant difference in a dental oncologist is that they go on to attend an additional one-year fellowship program after four years of dental school. This one-year fellowship program focuses on many areas of dentistry and cancer treatment. A major area of study during this program is making prostheses for patients who are undergoing surgeries due to cancer. Also, they address the oral side effects of cancer treatments. Mayo Clinic. They are trained extensively on medical oncology, radiation oncology, oral diagnosis, speech pathology, and more and are equipped to care for patients undergoing complicated medical procedures such as those to treat cancer. 

Although our dentists at South Lincoln Family Dentistry are not trained dental oncologists, we are able to help with many oral health needs that arise before, during, and after treatment. We will also gladly work with your dental oncologist to discuss dental treatment needs. It is good to ask your oncologist if there will be a dental oncologist to work on your team of providers wherever you seek treatment. 

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What if I can’t find a Dental Oncologist?

General dentists are trained to help evaluate any oral concerns that should be taken care of before cancer treatments begin. It is most ideal that the initial meeting with your dental team will occur approximately one month before cancer treatment. Any invasive procedures, like extractions, should happen, at minimum, two weeks before radiation begins. Your dentist will target and treat oral infection sources that may be present, such as gum disease or cavities. It is also important that your dentist evaluate potential areas of oral trauma from things such as ill-fitting orthodontic appliances or dentures.

Once treatment has begun, it is best that non-emergent treatment needs be discussed with your oncology team and be delayed if possible. This includes any new dental prosthetics. If radiation is completed, patients should visit their dentist more regularly as many side effects from this treatment present themselves after treatment is completed. 

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Most common oral side effects. What are they?

Cancer treatment(s) can harm rapidly dividing cells. Many of these cells are located within the mouth, according toBreastcancer.org. For this reason, we know that cancer therapy can lead to having many oral side effects. Luckily, however, all of these issues can be treated by your team of dental oncology professionals or dentists for cancer patients. As explained by a review inStomatological Disease and Science, some of the specific areas they focus on include:

Infections 

  • Seeing your dentist prior to treatment to ensure your mouth is free of active gum disease and dental decay can aid in preventing infections. 

Mucositis

  • Painful inflammation of the oral tissues. Some dentists can manage this with oral rinses and topical anesthetics.

Extreme dry mouth

  • This can be temporarily relieved by drinking lots of water and chewing sugarless gum.

Changes in Taste or loss of taste

  • Changes in your ability to taste might reside on its own in the weeks after treatment.

Problems swallowing

  • This is also called dysphasia. Dysphasia means having trouble swallowing food or getting liquid down the throat. Some people describe dysphagia as feeling as something is caught in their throat. Other people may feel as if trying to swallow causes them to gag or cough. Dental oncologists could address difficulty swallowing, with home remedies or medications. Eating soft foods may be another recommendation that a dental oncologist may make, reports the American Society of Clinical Oncology.

Oral Thrush

  • Oral candidiasis, or oral thrush, is a prevalent problem for patients with dry mouth.
  • Thrush can cause pain and oral burning. The appearance of thrush in a patient with dry mouth often appears like “white cottage-cheese.” The tongue might show grooves, and the corners of the lips appear red and crusty, which is called angular cheilitis.
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What is burning mouth syndrome? Can dentists for cancer patients or general dentists help with burning mouth syndrome?

Another concern that could arise for cancer patients during treatment is burning mouth syndrome. What is burning mouth syndrome? Burning mouth syndrome is exactly what you might think. It is  a chronic or recurrent burning in the mouth without an apparent cause. Burning mouth syndrome can affect areas of the mouth such as the lips, gums, tongue, roof of the mouth, and even the inside of the cheeks. The burning sensation can be quite severe and, in some cases, can seem as though you have burned the inside of your mouth. Many times, burning mouth syndrome appears suddenly. For this reason, it’s essential to work closely with your team of medical professionals to help manage the symptoms.

covering mouth Cancer and Your Mouth

Why do I have a metallic taste in my mouth?

Also, another side effect that those being treated for cancer might experience is a metallic taste in the mouth. This can happen for patients being treated with either radiation or chemotherapy. A metallic taste can occur from eating foods high in protein, such as meat. While not everyone experiences a metallic taste, it is common. There are multiple things you can try to help combat this issue. For more tips and ideas of things to try, go to Cancer.net. Again, all dentists for cancer patients can help address this concern.

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Are mouth ulcers common in cancer patients?

What about mouth ulcers? Although there is no definite cause, there are most certainly factors that trigger mouth ulcers. Generally, mouth ulcers and even canker sores are caused by some form of trauma. Radiation and chemotherapy, either alone or combined, can cause sores in the mouth. Why? Various forms of cancer treatment are intended to kill cells that quickly multiply, many of which happen to be cancer cells. Some completely healthy, normal cells within the body also grow and divide quickly. These same cells happen to be found on the inside of the mouth. Ultimately, those undergoing cancer treatment are more prone to developing mouth sores because they are undergoing treatment. To learn more about mouth sores and pain, visit Cancer.org. If you are prone to developing cold sores, see our tips on how to stop a cold sore. Although you may not be able to entirely eradicate the problem of mouth sores, there are most definitely things you can do to make them more tolerable.

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In conclusion:

Cancer can be an overwhelming process that incurs a long journey of both treatment(s) and recovery. We don’t want the oral side effects of any cancer treatments to add to you or your loved one’s plate.  Even though your oral health treatment plan may look a bit different from someone who does not have cancer, you and your comfort are extremely important to us. Dental treatment for cancer patients is critical, and your mouth is an incredibly delicate but vital part of helping you sustain and maintain health. Being able to eat, drink, and speak are all things anyone who is on this journey needs. Dentists who work with cancer patients, or a dental oncologist, will work diligently as part of a team of providers to help cancer patients in their journey – throughout the diagnosis, treatment, and recovery process. Don’t let cancer take control. Find a team of skilled professionals, including dentists that treat cancer patients, to help you. You don’t have to do it alone!