Cancers can be dreadful and doing whatever it takes in a medical sense to beat them is whole heartedly supported by me and the dental fraternity. It is, however, important to understand how chemotherapy treatments affect your dental health. Chemo, as many of you may know, is a broad spectrum anti-cancer drug treatment designed to kill cancer cells. It can stop or slow the growth of these and is often used in conjunction with other cancer treatments. Chemotherapy has side effects and not only destroys cancer cells but also other healthy cells, which grow and divide rapidly.

Chemo Side Effects & Oral Health

In particular, these include the cells lining your mouth and intestines. More famously, they include those that keep your hair growing and, thus, hair loss results from chemo treatments. It, also, makes you feel awful with nausea symptoms very prevalent. Fatigue is another common outcome during chemotherapy. Imagine living in a country where you were forced to pay for this on top of how crap it made you feel. Places like the United States, where the wonders of the free market force onerous private health insurance commitments upon individuals or the likelihood they will not be able to afford treatment or be denied authorisation by companies like UnitedHealthcare, which projects revenues of $450 billion this year. These issues are currently in the news at the moment for all the wrong reasons. In Australia, we are fortunate to be covered by Medicare, a universal free healthcare insurance for all Australians – excepting dental.

Chemotherapy Impacts On Your Oral Health

Better to be alive and have to manage the complications caused by chemo, I think. On that score most of us would agree I would imagine, than the alternative. Here are some tips from various experts on how to best manage your oral health during chemotherapy and afterwards. It is the mouth lining cells, mentioned above, which slows down the body’s usually fast acting repairs. Our mouths and the tissue there are, perhaps, the fastest cell growing area within the body usually. Things heal inside our oral cavity at a rapid rate, as dentists well know. During chemo this is not the case and mouth sores are common.

“Chemotherapy may lead to tooth decay or infections by weakening the immune system and slowing down the regeneration of oral cells. Side effects are usually short term, and practicing oral hygiene may help. Children may have long-term dental complications if doctors treat them with chemotherapy at a young age.”
– Medical News Today

In addition, the bacterial balance in our mouths gets upset and our immune systems are challenged to cope during chemo. Infections and tooth decay become far more likely as a result. More generally, your teeth will look and feel worse than they normally do. They may stain more easily and become discoloured. Grooves or pits may appear on the enamel surface. The roots of the teeth may, also, be affected. More cavities than usual and some patients may lose teeth. It can be a tough time for your oral health and this, of course, comes whilst you are feeling nauseous and fatigued. However, if you get through it, many of these dental issues will be short term and things will get better as the treatment concludes.

What Can You Do To Best Manage Your Oral Care During Chemo?

Firstly, consult with your dentist prior to the treatment and get their advice for what you can do during this challenging time. The dentist will recommend sorting out all outstanding dental care issues before starting chemo. It will be more important than ever to maintain a heightened dental hygiene protocol whilst undergoing chemotherapy. This may be hard but focusing on such things may provide you with a positive oral care ethic to focus on. It has been shown in studies that having a purpose during highly challenging times can be what gets some people through them. The mouth can, often, become very sensitive to substances during chemo and adjustments may have to be made regarding toothpastes and mouthwashes. If your usual toothpaste irritates, then salty water and baking soda can be an alternative. A quarter teaspoon of salt added to a cup of water for brushing teeth is adequate. It is advised to rinse every 2 hours with a quarter teaspoon each of salt and baking soda in half a litre of water to reduce soreness in the oral cavity.

“It is often a good idea to visit your dentist for a thorough check-up before starting cancer treatment. Tell the dentist about the type of treatment you will be having so they can develop an oral health care plan. It is especially important to see your dentist if you already have mouth problems or tooth decay, or if you are going to have high-dose chemotherapy, a stem cell transplant or radiation therapy to the head and neck area. If you are having radiation therapy to the mouth, your treatment team may require you to have a dental check-up before treatment starts. You may need to have any decaying teeth removed before starting treatment. There is a higher risk of infection and bleeding if you have dental work during cancer treatment.”
– Cancer Council

What About Chemo & Dentures?

It’s a fact that chemotherapy treatments do affect your dental health. Patients with dentures may develop fungal infections during chemotherapy. Candidiasis is the name of this fungal infection and symptoms include – taste changes and a burning painful sensation. Dentists advise soaking dentures in an antifungal rinse to manage this.

Dry Mouth A Common Chemo Issue

Dry mouth is a common symptom during the taking of Chemotherapy drugs. Dry mouth and lack of saliva creates the optimal conditions in the mouth for bad bacteria to flourish causing infection and decay. It is advisable to sip water often to combat this by keeping the oral cavity moistened.
Other Oral Health Issues During Chemo
• Bleeding inside mouth
• Sore teeth & gums
• Oral Mucositis (inflammation of mouth membrane)
• Numb lips & mouth
• Sore mouth & lips
• Difficulty swallowing
• Stiffness of jaw & surrounds
• Infections
• Loss of bone & tissue

Kids & Chemotherapy: Dental Health Studies

Chemotherapy can have longer term effects upon children and their oral health, studies have found.

“However, chemotherapy may affect tooth development in children. A 2018 systematic review with meta-analysis combined the results of several studies that followed people diagnosed with cancer as children for up to 22.9 years to examine how chemotherapy affected tooth health over time. The researchers found that 1 in 7 children who had chemotherapy may have at least one missing tooth that would otherwise have developed. They also suggested that other side effects included discoloration and increased cavities. A 2023 review found that 53% of people who had cancer therapy in early childhood had crown-root malformations and missing teeth.”
– Medical New Today, 2024

Our Oral Health is Vulnerable

So how do chemotherapy treatments affect your dental health? In conclusion, oral care is highlighted as a particular thing to pay attention to during chemo drug therapy. Quite simply, our oral health is vulnerable to the affects of chemotherapy and, therefore, requires extra attention. See your dentist at least 4 weeks prior to starting chemo if possible and together make a plan. Forewarned is forearmed, as they say. Wishing you the best in your healing if you are facing these challenges.

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