The Canadian Cancer Society is here to support and inform you through a cancer diagnosis. Your dentist can support you in good dental health along the way.
It was estimated in 2015 that 196,900 new cases of cancer would be diagnosed in Canada, and in the US in 2016 the number of new diagnoses of cancer is estimated to be 1,685,210. Often times, once that word “cancer” is heard by a patient or family other health care services are completely forgotten. However, with early detection and improvement in cancer treatment a higher survival rate can be expected than ever before. I know the last thing on a patient’s mind is their teeth, but there are important screenings and treatments available to ensure good oral health before, during, and after cancer treatment.
In some cases, there is some time between receiving a cancer diagnosis and beginning treatment, and this is actually an ideal time to visit the dentist, especially if it has been a while. The best thing a dentist can do at this point is take a full series of dental xrays (with digital xray to significantly reduce radiation) and create a dental plan for all necessary dental work to be completed by two weeks prior to cancer treatment.
Any hopeless teeth should be removed 7-10 days before chemotherapy treatment, and for children any loose baby teeth or teeth expected to become loose during cancer treatment should be removed to limit bacteria transmission. For patients at high risk for cavities, a fluoride varnish should be placed on the teeth by your dental hygienist after dental cleaning. Your hygienist can give you excellent advice for different techniques and tools to help with your oral care during chemotherapy. As well, soft trays can be made to have the patient use a prescription fluoride formula daily for 10 minutes each day.
If there will be radiation in the head and neck area, your dentist and dental laboratory can make a custom-fitted guard to protect your teeth from the extra radiation. This is important as cancer radiation therapy can significantly speed along any small areas of dental cavities. There may also be a need for your dentist to prescribe certain medications to help with dry mouth or fungal infections which can develop when undergoing chemotherapy or radiation.
During cancer treatment, your oral care may need to change to keep you in best health. Carefully clean the teeth after every meal or snack with an extra-gentle toothbrush. Once per day, it is a good idea to use a prescription-strength toothpaste and the rest of the time you should use one that is SLS-free (non-foaming). Make sure to floss every day unless you have a low blood count; in that case, an oral irrigator (Waterpik) on a low setting will be very effective. Use an alcohol-free mouthwash every night before bed to reduce the number of oral bacteria and the possibility of inflammation.
It is common during cancer treatment to feel unwell. After vomiting, rinse your mouth with a solution of 1/4 teaspoon baking soda, 1/4 teaspoon salt, and 1 cup warm water, swishing everywhere. Wait at least 30 minutes before brushing teeth to as not to further damage any areas possibly weakened by acids. You can also use oral gels and lozenges such as Biotene products or sugar-free candies to help keep the mouth moist, and sipping on water or ice chips throughout the day is also useful.
Finally, have your teeth professionally cleaned every 8 weeks during cancer treatment as your blood counts allow. Always check with your oncologist prior to treatment, but keeping the bacterial count in your mouth low is best for overall body healing. As well, these more-frequent dental appointments can counteract any negative effects from possibly having less-than-perfect home dental hygiene. Your dentist can make specific recommendations to you about the best way to prevent dental problems while your body focuses on healing.
Dr. Andrea Stevens is a cosmetic and family dentist in practice in Kanata, Ontario. If you have dental questions, you can call her at 613-271-7091 or visit her at kanatacosmeticdentist.com Please also feel free to leave comments or questions below, and Dr. Stevens will be happy to answer.