Oral side effects occur in almost everyone that receives radiation therapy for head and neck cancers, in more than 75% of those who have a bone marrow transplant, and in nearly 40% of those who receive chemotherapy. If you receive chemotherapy, your individual risk varies depending on the treatment regimen prescribed for you. If you receive mildly myelosuppressive therapy*, you are at low risk. If you are receiving single agent or outpatient therapy, you are at moderate risk. If you are receiving stomatotoxic chemotherapy resulting in prolonged myelosuppression*, or if you are receiving radiation for oral or pharyngeal cancer, you are at the highest risk.
*Myelosuppresive therapy decreases your bone marrows production of white blood cells (that fight infection), red blood cells (that carry oxygen and waste products), and platelets (that assist in blot clotting).
Some complications occur only while you are in treatment, others, such as dry mouth, may continue for years after treatment has ended. It is very important that you receive medically necessary oral care before serious complications develop.
Good oral care before treatment can:
- Reduce the risk and severity of oral complications
- Improve your chances to tolerate the optimal doses of cancer treatment
- Prevent oral infections that could lead to potentially fatal systemic (wide spread) infections
- Prevent or minimize complications that could jeopardize your ability to get your nutritional requirements met
- Prevent, eliminate, or control oral pain
- Prevent or reduce the incidence of bone necrosis (death) if you are receiving radiation therapy
- Preserve or improve oral health
- Improve your quality of life
See a Dentist before Treatment Begins
Your dentist is an important part of your cancer treatment. Ideally, you should see us prior to the start of your anti-cancer therapies. Your cancer therapy may be less traumatic if you work with your dentist and dental hygienist to maintain good oral hygiene. This can avoid potential serious problems that can be caused by your treatments. Children need special protection for their growing teeth and facial bones.
In addition to treating poor oral hygiene, your dentist can treat any silent dental infections. If untreated, these infections could cause delays in your treatment.
Optimally, you should visit us at least two weeks before beginning radiation or chemotherapy treatments. If you are already in treatment, see us as soon as possible.
Before your cancer treatment begins, your dentist will:
- Perform a complete oral and head and neck examination evaluating your teeth and oral tissues
- Identify and treat any existing infections, problem teeth, or problems associated with dental prosthetics
- Stabilize or eliminate potential sites of infection
- Remove orthodontic bands (if you will receive radiation therapy in that area or will receive highly stomatotoxic chemotherapy drugs)
- Evaluate your dentures and appliances for comfort and fit
- Remove any teeth that may pose a future problem to decrease the risk of serious bone infection for patients receiving head/neck radiation
- Remove loose primary teeth and eliminate any dental pathology that could lead to systemic infection and/or treatment delays for children
Your dental team will also provide instructions on:
- Good oral hygiene - special brushing and flossing techniques, how to use fluoride gels and mouth rinses, and other approaches to keep your mouth as moist and clean as possible in order to reduce the risk of infection and pain
- Techniques to help you maintain proper nutrition
- The need to avoid alcohol and tobacco