Coping with cancer, Mouth Care
22 March 2017
Patients who are receiving cancer therapy often experience side effects including changes in the mouth.
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  • If there is pre-existing dental infection such as cavities, abscesses, or gum (periodontal) disease, the infection may become worse. In addition, your gums may bleed easily if they are irritated or swollen. Chemotherapy may also cause mouth sores (mucositis).
  • If you receive radiation therapy it has long-term side effects in the mouth. The most common side effect is dry mouth (xerostomia). Placing you at higher risk for cavities and gum disease, as the normal protective effect of saliva on the teeth is lost.
  • Another side effect of radiation treatment is severe bone infection. This is caused by a decrease in the blood supply to the bones of the head and tissue of the neck during radiation treatment. These changes result in slow healing from infection, trauma or especially when teeth are removed soon after radiation therapy.
Here are some tips for mouth care that may help prevent or minimize these changes.
1. To prevent infection, discomfort and tooth decay, it is very important to see your dentist early pre-treatment
  • Teeth with severe infection or those that may cause problems during or after therapy should be extracted and allowed enough time for proper healing.
  • Teeth with cavities should be restored with fillings.
  • A thorough cleaning and scaling of teeth should be done to remove tartar (calculus). All sharp areas should be smoothed to prevent unnecessary irritation.
 2. Keep up healthy oral hygiene practices
  • Brush three times a day with a soft toothbrush
  • Floss daily
  • Eat a nutritionally balanced diet, low in sugar
3. During treatment, it is important to adhere strictly to your mouth care plan. If your mouth is sore, some of the following tips may help:
  • Use a soft toothbrush or a sponge applicator such as a toothette to brush your teeth
  • Don't floss if it causes bleeding when your platelet count is low
  • Wear dentures only for meals
  • Rinse your mouth with warm salt water or baking soda and water (a teaspoon of either dissolved in eight ounces of warm water) or a prescribed antibacterial rinse. Avoid commercial mouthwashes because they contain alcohol that may burn your mouth
  • To prevent discomfort when eating, you may apply a topical anesthetic to your mouth, especially before meals. Ask your doctor or nurse about specific products.
  • Pain medicine may also be used. Tylenol or stronger pain medication may help reduce oral pain. If taken half an hour before meals, it may be more comfortable to eat. It is important to avoid using aspirin or non-steroidal medication products while on chemotherapy since they may cause bleeding problems
  • Do not smoke or chew tobacco and avoid drinking alcohol and caffeinated beverages as these are all very irritating and drying to a sore mouth.
  • Avoid spicy food and food that is difficult to chew. Citrus and tomato juice may irritate your mouth when you have mouth sores.
  • There is prescribed medication to treat & prevent sores. However, you can also ask for an ice block or sugar free ice lolly to suck on while you are receiving chemotherapy. Research has shown this may decrease mouth sores by 60 percent and help with discomfort.
  • Dry mouth (xerostomia) can be helped by drinking plenty of fluids throughout the day. Drink at least eight glasses of water
  • Artificial saliva can be tried and is available in most pharmacies. You may find that chewing sugarless gum or sucking on sugarless candy is helpful. Coating your lips with a lip balm such as Vaseline or Chapstick will help prevent them from cracking. A cool mist humidifier will add moisture to your room.
  • Fluoride treatments are important during and after radiation treatments They should be done twice daily by using soft trays that are custom made for you by your dentist.
4. When to call your doctor
  • If your mouth pain increases and you are unable to control it with your pain medicine.
  • If you are unable to eat or drink because of severe mouth sores.
  • If you have a fever.
  • If you have bleeding that is difficult to control.
  • If you have any difficulty swallowing.

Source : Dana Farber Cancer Institute

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Mrs. L. attended the unit in February 2006. She was extremely unhappy with her complete dentures, which she has been wearing for two years.