Cancer treatments can be almost as unpleasant as the disease itself, and most people, even those not affected by cancer, know of the deleterious side effects of radiotherapy and chemotherapy. However, many people are unaware of the oral complications that cancer treatments can induce, even though over a third of cancer patients will suffer from them during or after treatment.

With this in mind, it is important for cancer patients, or people caring for them, to pay close attention to their dental health, and take some extra precautions to avoid damage and disease as much as possible.

Everyday dental hygiene during and after cancer treatment

Keeping up a rigorous oral hygiene regimen is just as important in sickness as it is in health, but cancer treatments can complicate matters. Radiation and chemical therapy can make the gums tender, swollen and prone to bleeding. As such, daily routines have to be altered slightly:

• Brushing should be done with a very soft toothbrush. Dentists often sell special, soft bristled brushes for people with compromised gums.
• Flossing should be done daily, but very gently. Floss harps and interdental brushes are good alternatives if traditional floss is difficult to use. Do not floss around swollen or bleeding areas of gum.
• Mouthwash should be gentle and contain no alcohol.
• Some dentists recommend periodically swishing the mouth with a weak solution of salt and baking soda in water. This helps to kill infectious microbes, and compensates slightly for the mouth's weakened immune system. 
• Patients should also seek to supplement their regimen with fluoride treatments. Ideally a fluoride gel should be used, instead of standard fluoride mouthwash solutions.

Dealing with complications from cancer treatments

Side effects from chemotherapy and radiotherapy can range from the merely inconvenient to the genuinely serious, so it is important to try and recognise the early symptoms of a condition before it worsens. Below are some (but not all) of the most common side effects of cancer treatments:

1. Dry mouth—A very common side effect, impinged production of saliva caused by treatments can leave the patients with a dry, possibly painful mouth. Reduced saliva levels can also cause ulcers and sores to form, as well as increasing the risk of tooth decay and gum disease.

Artificial saliva substitutes are available to alleviate symptoms. You can also keep saliva flow constant by chewing sugar free gum or sweets, as well as staying properly hydrated. Using a room humidifier can also be helpful.

2. Tooth decay—Radiotherapy in particular can result in rampant tooth decay, and the semi-permanent irradiation of the teeth and jawbone means that tooth decay often becomes a lifelong concern. Visiting a dentist frequently to monitor for signs of decay is highly recommend, as is the aforementioned fluoride treatment.

3. Oral bleeding—Cancer treatments usually cause a reduction in the amount of platelets present in the blood. Platelets are responsible for clotting blood and creating scabs, so cancer patients are much more likely to encounter oral bleeding, particularly if they brush or floss too hard.

Keep brush and flossing firm but gentle, and try to avoid acidic food and drinks. If bleeding is profuse or does not stop for a long time, seek emergency dental treatment. Low platelet counts also make invasive dental work and dental surgery a more complicated affair, so be sure to keep the dental practitioners well informed.

4. Osteonecrosis of the jaw (ONJ)—This occurs when radiotherapy reduces the low jawbone's blood supply, causing the affected portions of bone to die. Symptoms generally include an aching pain in the jaw and stiffness in the lower face muscles.

Good dental hygiene can significantly reduce the likelihood of ONJ occurring. Treatments for ONJ in cancer patients are generally conservative, due to the risks of surgical intervention. Antibiotics, painkillers and antiseptic mouth rinses are generally prescribed. 

Learn more about how you can maintain your oral health by consulting clinics such as Buderim Marketplace Dental.