Oral care during cancer treatment

Dirna Grobbelaar, Ivohealth’s oral hygiene advisor, shares tips to prevent oral complications during cancer treatment, and advice on what to do, should they arise. 

It’s quite common to experience oral health problems during cancer treatment, with about a third of patients experiencing dry mouth, mouth ulcers, tooth decay and infections. 

What causes oral health problems?

There are several potential causes of dental and oral complications during medical treatment. Chemotherapy, and radiation (particularly of the head and neck) can cause dry mouth and mouth ulcers. As can certain pain medication and other drugs. 

Chemotherapy can also temporarily reduce the body’s ability to fight infection, making you more susceptible to mouth infections. You may find that underlying dental problems flare up during treatment. 

How to prevent them?

If your mouth is in good health, you’re at lower risk of oral complications during treatment. Here are some pointers:

  • Visit your dentist for a thorough check-up, including X-rays, ideally a month before your treatment starts. This allows time to detect and treat underlying decay or infection. 
  • Optimally, there should be at least two weeks between any dental surgery and starting of treatment.
  • If you wear dentures, check their fit, to ensure they aren’t irritating the mouth. 
  • If you have orthodontic brackets (braces), it might be best to remove them for the duration and reapply once treatment is completed.
  • It’s advised to see the oral hygienist for a professional clean and polish after diagnosis, to remove any plaque and tartar build-up.
  • Your diet plays an important role as well. Avoid alcohol and caffeinated drinks, and very salty, spicy, cold, acidic or rough foods that may irritate or dry out your mouth. 
  • Oral bacteria thrive on sugar, so reduce it as much as possible and adopt a nutritious, healthy diet with plenty of calcium and vitamin D.
  • If you experience nausea and vomiting, don’t brush teeth immediately afterwards; stomach acid demineralises enamel and weakens teeth. Initially, just rinse your mouth with water, or an alcohol-free mouthwash, then wait an hour or so before brushing. 

The ideal daily oral care routine

Meticulous oral care is important, during cancer treatment, to keep the mouth clean and prevent decay. Follow the oral care routine below:

  • Brush correctly, at least twice a day, for a full two minutes each time, right up to the gum line.
  • A soft brush will be gentler and cleans just as effectively.
  • Dipping the brush in warm water beforehand will soften the bristles.
  • Strong tasting toothpastes may irritate the gums; rather use a mild toothpaste, or Olgani Naturals toothpaste.
  • If you experience bleeding gums or infection, consider a treatment paste, like Sunstar GUM Paroex Gel.
  • Clean in-between the teeth daily. If you find floss too firm, try an interdental brush, or gentle Sunstar GUM Soft-Picks. The oral hygienist can give advice on which tools will work best for your mouth.
  • After eating, or for extra freshness, rinse with an alcohol-free mouthwash. Dentyl Dual Action is oil-based and gently moisturising, with the same pH as saliva. Alcohol-based mouthwashes should be avoided, as alcohol will dry out already sensitive oral tissue.
  • You may feel extremely tired during treatment, but try not to let that negatively impact your oral care routine. A quality electric toothbrush, like the Philips Sonicare Powerbrush, will give a ‘supreme clean’ with minimum effort.

Dry mouth

With more than 400 commonly prescribed medications listing dry mouth as a potential side effect, including many chemotherapy drugs, there is a good chance you may experience reduced saliva flow, at some point, during your treatment. 

The lack of saliva makes swallowing, and even talking, difficult. In severe cases, sufferers can become malnourished and    lips can become dry and cracked. Because saliva is the body’s way of keeping the mouth clean, plaque and bacteria build-up more quickly increasing the likelihood of bad breath, gum disease and dental decay. Rehydrating the mouth is   the number one priority. Drinking water will give temporary relief,  and chewing gum can stimulate saliva flow. There are also medications that help produce saliva: new Sunstar GUM Hydral Moisturising Gel and Spray lubricate oral tissues, soothe irritation, promote soft tissue repair and create a protective coating in the mouth, giving longer lasting relief. 

Smoking is a big no-no for everyone, even more so if you suffer from dry mouth. Sleeping in a room with a humidifier may also assist dry mouth.

Mouth ulcers

Mouth ulcers can be painful because they expose sensitive nerve endings which can make drinking, eating, talking and cleaning your mouth uncomfortable. However, maintaining good oral hygiene can promote quicker healing and will help keep your teeth and gums healthy.

After eating and before going to bed rinse with an antibacterial mouthwash, like GUM Paroex, or all-natural Olgani to promote healing. 

Drinking with a straw (eco-friendly) can help ‘bypass’ the ulcer.

Several products are available at pharmacies that help relieve the pain of mouth ulcers. Aloclair contains soothing aloe vera and forms a barrier over the sensitive nerve endings to give immediate relief. 

If you do experience any dental or oral side effects during your treatment, chat to a member of your healthcare team – such as your doctor, nurse or dental professional. Managing symptoms will help alleviate any pain and discomfort when eating, drinking and talking – a critical part of your care and recovery.

For further expert advice on looking after your health during cancer treatment, download our ‘Love Your Life, Love Your Oral Care’ booklet on the Buddies for Life website or email us on [email protected] to request your free copy. 

Dirna Grobbelaar qualified as an oral hygienist in 1999. She consults to Ivohealth, and also works in practice part-time to keep up-to-date with the latest trends, information and patient concerns.

MEET OUR EXPERT – Dirna Grobbelaar

Dirna Grobbelaar qualified as an oral hygienist in 1999. She consults to Ivohealth, and also works in practice part-time to keep up-to-date with the latest trends, information and patient concerns. 

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