Of all the side effects of chemotherapy, the effects on the mouth are the worst and most uncomfortable. Chemotherapy drugs target rapidly dividing cells throughout the entire body. Your mouth has a vast amount of rapidly dividing cells and that is why the mouth is most affected by the life-saving treatment of chemotherapy.
Gum disease can be present even before chemo starts. Your immune system’s response is negatively affected by chemo and doesn’t function as well as it should. Chemotherapy may trigger gum inflammation which increases the incidence of gum disease. If gum disease is present, chemo will aggravate the gum disease and make treatment more difficult. Of the utmost importance is to visit your dentist BEFORE chemo starts!!! This will give your dentist the opportunity to treat your gum disease (if you have) before chemo commences and will help and advise you how to prevent it from happening again. Gum disease is medically known as Gingivitis. This is recognised by red, swollen gums that bleed if you brush, floss or touch them. Only the gums are affected at this stage of gum disease. If left untreated, gingivitis progresses to Periodontitis. Periodontitis is characterised by bone loss around the tooth and inflamed gums. Severe gum disease causes at least one third of adult tooth loss due to the loss of the supporting bone around the tooth. Tooth loosening and tooth loss are the consequences of untreated periodontitis. Recent clinical studies have shown a direct link between poor oral hygiene (oral bacteria and infections) and serious systemic diseases such as Cardiovascular Disease (heart attack and stroke), Bacterial pneumonia, Low birth weight, Diabetes complications and Osteoporosis.
Gum disease does NOT happen overnight and progressively starts due to a lack of plaque removal. If plaque is not removed for some time, it mineralises/hardens and forms a cement-like layer namely calculus or tartar on the tooth. In this tartar state, the bacteria release acid in a protected environment as neither tooth brushing nor flossing can remove it from the tooth surface.
Treatment of gum disease starts with removing the offending plaque and tartar. This should be done by your dentist to ensure complete removal. Your gums WILL bleed. Bleeding is a sign of infection and that the body is trying to fight the disease. If gum disease has progressed to periodontitis, your dentist may place you on a low dose of antibiotics to help suppress the infection. A medicated mouthwash will also be prescribed. It is very important to avoid mouthwashes containing alcohol during chemo. They tend to burn your gums and deter you from brushing properly. An easy to make and inexpensive salt- and- soda solution (¼ teaspoon baking soda and 1/8 teaspoon salt in a glass of warm water) mouthwash is a great alternative.
Gum disease and periodontitis are preventable! The trick is to not let the disease start! It is so simple as brushing your teeth twice a day and flossing once a day. Chemo is taxing enough as it is and your gums should be the last of your worries.
Written by Carine van der Linde