Oral care in cancer patients

Patients undergoing cancer treatment often have changes in the oral cavity. The article will analyze the possible side effects of the mouth during cancer treatment, along with oral care tips to help prevent or minimize those side effects.

Chemotherapy affects rapidly dividing cells, cancer cells, and some normal cells, such as cells of the lining of the mouth, digestive tract, bone marrow cells, and hair cells that often divide very fast.
Chemotherapy cannot distinguish between normal cells and malignant cells and sometimes damages both. Chemotherapy can cause bone marrow suppression, thereby reducing the number of white blood cells, platelets and red blood cells, increasing the risk of infection and bleeding.
If there are pre-existing infections in the mouth such as tooth decay, gingivitis (periodontitis), the infection may become worse. In addition, gums can bleed easily if they become swollen. Chemotherapy can also cause inflammation of the lining of the mouth (oral sores). These sores usually heal in one to two weeks, however, more serious sores are more susceptible to bacterial or yeast infections in the mouth. Your doctor can prescribe medications that prevent sores and help ease discomfort. Unsweetened shaved ice or popsicles can be used to suck on during chemotherapy to help make your mouth more comfortable. Research has shown that they can help reduce mouth sores by 60%.

Radiation therapy is often used to treat cancer in the head and neck area. Similar to chemotherapy, radiation therapy destroys cancer cells, but some normal cells may also be eliminated. During radiation therapy, patients may experience inflammation of the oral mucosa, and symptoms usually subside within a few weeks after the therapy ends.
The most common side effect of radiation therapy for cancer is dry mouth (xerostomia). Dry mouth is often the result of radiation damage to the salivary glands, which means fewer salivary glands and denser saliva. The protective effect of saliva on missing teeth and an increase in oral bacteria that cause cavities. In addition, teeth appear more plaque and tarnish faster, putting you at greater risk of tooth decay and gum disease.
Another side effect of radiation therapy to the head and neck area is a severe bone infection. It is caused by decreased blood supply to the bones of the head and tissues in the neck during radiation therapy. These changes make the wound slow to heal due to infection and trauma, especially in cases where the tooth is removed immediately after radiation therapy. Restoration and preventive dental care are important to avoid infection. Therefore, to be able to prevent infection and tooth decay, it is important to see your dentist early for treatment and to continue daily oral hygiene.

Need to see a dentist so that potential infections or tooth irritation can be identified. Severely infected teeth or teeth that could cause problems during or after treatment should be removed (extracted). Extractions should be performed at least a week before chemotherapy or radiation therapy is started to allow time for healing. Tooth decay needs to be restored with dental fillings along with cleaning and removing tartar.
During the first dental visit, procedures may include:
Dental exams and X-rays Oral hygiene Fluoride coating: Fluoride is used to help prevent the formation of cavities. Instructions for oral hygiene by brushing three times a day with a soft toothbrush. Floss daily and apply fluoride gel to teeth with custom aligners twice daily. Eat a nutritionally balanced, low-sugar diet

During treatment, it is important to strictly follow the oral care plan. If your mouth hurts, some tips may help:
Use a soft toothbrush or disposable dental sponge to brush your teeth. Do not floss because it can cause bleeding. Only wear dentures during meals. Gargle with warm salt water or baking soda mixed with water. Avoid commercial mouthwashes, which often contain alcohol, which can burn your mouth. Antibacterial mouthwash or antifungal lozenges should be spaced at least an hour apart if both are included in the prescription. To avoid discomfort while eating, your doctor may prescribe Lidocaine (an anesthetic) to take before meals. Pain relievers may also be prescribed. If taken half an hour before a meal, the patient may be more comfortable eating. It is important to avoid using aspirin products or non-steroidal anti-inflammatory drugs (NSAIDs) during chemotherapy, which can cause bleeding problems. Do not smoke cigarettes, cigars and avoid alcohol. Avoid spicy, hard to chew foods. Juice from oranges and tomatoes can irritate the mouth in patients with oral mucositis. Drink at least eight glasses of water or juice each day. Avoid beverages containing caffeine because caffeine can increase dry mouth. You can try using artificial saliva. In addition, chewing sugar-free gum or sucking on sugar-free candy is also a useful solution to help saliva production. Fluoride treatments are important during and after radiation therapy to the head and neck area. This method needs to be done twice a day. How to proceed as follows:
Brush your teeth with fluoride toothpaste Put about 4 drops of fluoride gel into the hollow of your teeth in a plastic tray (special tool) and spread it with a cotton swab. Place the tray in your mouth and hold it for 5 minutes. Try not to swallow fluoride. Remove the tray and do not rinse your mouth or drink any food or drink for an hour. Rinse the tray. Repeat this routine twice a day.

When therapy is over, the patient should continue to take good care of their teeth to keep their teeth and gums healthy. The salivary glands will produce less saliva and the person is still at risk of tooth decay and gum disease. At this point the patient needs:
Visit the dentist for tartar and cleaning at least three times a year. Continue fluoridation treatment twice a day. A balanced, low-sugar diet. The tooth may need to be extracted if necessary. Dry mouth may continue after treatment. The amount of saliva will gradually increase, but may not return to normal. To add moisture to the mouth, the sick person should:
Bring a water bottle to wet the mouth when needed. Limit caffeine as much as possible. Avoid alcohol and tobacco products. Moisten foods with gravy or sauces. Suck on sugar-free candy or chew sugar-free gum. Use a cooling nebulizer. Dentures can be used or redone about six months after treatment. Taste changes in the first six months after radiation therapy are quite common. Patients may notice decreased taste and altered taste sensations, which often reduce appetite. Therefore:
Try different foods, if not satisfied, can try again another time. Add a variety of herbs and mild spices. Avoid adding salt if you have high blood pressure. Add liquid supplements to increase calorie intake until cravings return. Monitor your weight regularly until your weight is stable. In fact, cancer treatment methods always affect the patient's oral health, thereby causing difficulties in eating and talking. At this time, the patient should seek the help of a specialist to get the best control.
Vinmec International General Hospital is the address for examination and treatment of many diseases from simple to complex. With a team of qualified doctors and modern medical equipment, we will support and bring the best treatment results for each patient case. Currently, the hospital also develops many individual and package examination services such as: general health examination, cancer screening ... so depending on the current health status, customers can choose and visit examined by a doctor, specialist at the hospital.