1014 JADA, Vol. 133, July 2002


Patients who undergo cancer treatment sometimes are unaware that it can affect the teeth, gums, salivary glands and other oral tissues. In some cases, patients delay or stop their cancer treatment because they experience painful side effects in their mouths. To help manage these oral side effects, the dentist and oncologist can work together—before and during cancer treatment—to make recovery as comfortable as possible.

Chemotherapy and radiation treatments can cause several oral side effects:
  • inflammation and ulceration of the mucous membranes;
  • painful mouth and gums;
  • an increase in the risk of developing oral and systemic infections;
  • xerostomia (commonly called “dry mouth”), a condition in which saliva is thickened, reduced or absent;
  • rampant tooth decay;
  • burning, peeling or swelling tongue;
  • stiffness in the jaw;
  • impaired ability to eat, speak or swallow;
  • change in ability to taste;
  • poor diet because of problems with eating.

When possible, schedule a thorough dental checkup at least two weeks before treatment begins. At this visit, you can update your medical history record and provide the telephone number for the physician who is handling the cancer therapy.

During cancer treatment, you should continue to gently brush teeth twice a day unless the dentist recommends otherwise. You should use fluoride toothpaste and look for products that display the American Dental Association’s Seal of Acceptance.

Patients who receive cancer treatment of the head and neck sometimes discover that they cannot tolerate the flavor of their regular toothpaste. If this happens to you, you can try another flavor that will not irritate mouth tissues. Continue to gently floss once a day. If the gums are sore or bleeding in places, you should avoid those areas but continue to floss other teeth until the condition improves.

Your dentist may recommend a mouthrinse in addition to daily brushing. You also may be advised to use fluoride gel at home to help reduce the likelihood of tooth decay.

Rinse your mouth several times a day with a solution of baking soda and salt, followed by a plain water rinse. Use one-quarter teaspoon of baking soda and one-eighth teaspoon of salt in one cup of warm water. This is particularly helpful if you experience vomiting after cancer treatment.

If xerostomia develops, your dentist may recommend a saliva replacement, available at pharmacies. Taking frequent sips of water, sucking on ice chips or sugar-free candy, or chewing sugarfree gum may provide relief.

Eat a balanced diet. Soft, moist foods such as cooked cereals, mashed potatoes and scrambled eggs may be suitable if your mouth is sore. Avoid using tobacco and alcohol and schedule regular dental checkups. Your dentist and physician both want your treatment to be as safe and effective as possible.

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