Receiving a cancer diagnosis is shocking and scary for anyone. I have known many people in my life who have had one cancer or another. Some have made it through aggressive treatments; others haven’t been so lucky. Advances in research and clinical discoveries by doctors and other health care professionals have created holistic strategies for cancer treatment and management. One of the essential aspects of any holistic care plan is looking after your oral health.
Bacterial and odontogenic infections (odontogenic being the fancy word for ‘tooth developed infections inside or around the tooth’) are the most common types of infections worldwide; the mouth is vulnerable to infections simply by being open to the environment and for what we do or do not put into it. One of the major problems for cancer patients is a lowered immunity which gives rise to infections and their spread.
For people undergoing cancer treatment, the risk of bacterial or odontogenic infections is heightened because of compromised immunity and lowered white blood cell count. Bacterial infections and periodontal pathogens can cause serious complications for cancer patients and their treatments, particularly those going through radiation and chemotherapy; these treatments can cause or make oral health issues much worse. Extreme dry mouth is one complaint I hear a lot from my patients. So is being prone to more gum inflammation, gum recession, and bacteria buildup. Gums might even be sensitive. Complications can also include oral mucositis (the breakdown of the mucosal lining in the mouth, which creates mouth ulcers), taste changes, and tongue pain. Oral complications are one of the most frequent reasons cited for altering or ending cancer therapies. It’s easy to see how dentistry plays an important role in ensuring cancer patients are able to successfully and more comfortably complete their treatments.
Chronic dental issues, including those that never really caused much issue previously, must be addressed before cancer treatments start. Radiation and chemotherapy put the body in a very compromised state, raising the likelihood of acute infections or other complications.
Dentists aim for treatment to be completed a minimum of 1-2 weeks prior to the start of radiation therapy or chemotherapy to allow for healing time. Areas of focus for my patients include:
- Providing education on the effects of treatment, strategies for prevention and management
- Completing comprehensive oral soft and hard tissue exams and imaging
- Developing a dental management plan for treatment
- Providing topical fluoride (dentate) – for both home-based and in-office treatment
- Counselling on oral hygiene and dietary habits
- Optimizing long-term outcomes, factoring in the patient’s capabilities, compliance, access to care, financial resources, and other factors
Important outcomes for cancer patients include:
- Pain management and prevention – including mucositis
- Oral decontamination – emphasizing oral/dental hygeine, preventing dental caries, and managing oral mucosal infections (bacterial, viral and fungal)
- Oral moisturization – saliva management, stabilizing pH, and lip lubrication
- Controlling bleeding – managing dental emergencies and reducing any pre-existing risks of bleeding
Oral health is deeply connected to your overall health. During illness or other serious medical treatments, considering every aspect of your overall health will create the best outcomes possible.