Health Matters Related to Periodontal
oral hygiene methods
oral care products
your role in therapy
nutrition and vitamins
For Dental Health Professionals
of interest in Periodontics
Online Continuing Education
Maintaining Oral Health During Cancer
(the following has been published by The
American Academy of Periodontology in a brochure under the same name)
Almost half of all American adults have some form of
periodontal disease. The majority of them do not even know they have it. Periodontal
diseases are bacterial infections of the gums, bone and other supporting structures of the
Periodontitis, a form of periodontal disease, is one of the
primary causes of tooth loss and is usually painless and silent until its advanced stages.
Symptoms can include:
|Persistent bad breath |
|Gums that bleed when you brush your teeth
|Red, swollen and tender gums |
|Gums that have pulled away from the teeth Loose or
separating teeth |
|Pus between the gum and tooth |
|A change in the way your teeth fit together when you bite
Periodontal diseases can be diagnosed and treated by your dentist and/or periodontist.
A periodontist is a specialist with advanced training in the prevention, diagnosis and
treatment of diseases affecting the gums and supporting structures of the teeth.
Some forms of periodontal diseases have also been linked to
other significant health problems, including heart and respiratory diseases, diabetes,
osteoporosis and premature and underweight births of babies.
Just as periodontal health can affect your overall health,
certain health conditions and their treatments can affect your periodontal health. One of
these is cancer therapy.
If you or someone you know has been diagnosed with cancer,
it is essential to make the periodontist or dentist a member of the cancer team. Cancer
therapy can cause oral complications that compromise periodontal health, so a visit to
your dental professional is important to help you keep your gums healthy.
Prior to beginning your cancer treatment, an oral
evaluation by a periodontist or knowledgeable dental professional is important.
Identifying and correcting potential oral problems may ease discomfort so it does not
intensify or interfere with your cancer treatment. Oral surgery is not recommended during
cancer therapy, because tissues take more time to heal. This is why oral pretreatment is
essential. Pretreatment care also provides the following benefits: Reduces the risk and
severity of oral complicationsduring cancer therapy Reduces the chances of oral pain and
ultimately may protect oral health Allows for timely diagnosis and treatment of existing
infections Improves the chances of receiving optimal doses of cancer treatment Improves
Daily Oral Hygiene Routine- In addition to pretreatment care, your periodontist or dental
professional likely will recommend an at-home oral hygiene routine. Daily oral hygiene
will provide comfort reduce the risk of infection by periodontal bacteria, and minimize
the effects of complications caused by your cancer treatment. In addition to the oral
hygiene routine tailored by your dental professional, following are some tips to help you
keep your mouth as comfortable and healthy as possible:
|Gently brush your teeth, gums and tongue
with a soft- bristled toothbrush and fluoride toothpaste after every meal and before bed.
|If brushing hurts, soften the bristles in warm water.
|Floss teeth gently every day temporarily avoiding areas if
gums are sore or bleeding. |
|Topical fluoride applications may be prescribed by your
dental professional. Fluoride applications will fortify the enamel to help it resist decay
caused by decreased saliva production during radiation therapy. |
|For a sore mouth, rinse a few times a day with one cup of
warm water mixed with '/4 teaspoon baking soda and '/s teaspoon salt. Follow with a plain
water rinse. |
|Avoid candy and soda unless it is sugar-free. Also
avoid using toothpicks, tobacco products and
Even though pretreatment and daily
oral hygiene can go a long way toward keeping your mouth comfortable and disease-free
during cancer treatment, sometimes it's hard to keep the negative effects at bay. If you
are experiencing one of these problems, there are a few easy steps you can take to
minimize discomfort and the harm it causes.
Caring for Dry Mouth- Chemotherapy and radiation can decrease your salivary secretion causing
excessive dryness in the mouth. And, a dry mouth could increase your susceptibility to
oral infections.Keep your mouth moist and stimulate saliva flow by:
|Sipping cool water often |
|Allowing ice chips to melt in your mouth
|Chewing sugarless gum or candy |
|Lubricating your lips with lip balm
|Asking your dental professional for a prescription saliva
substitute or medication that may stimulate saliva |
|Using a humidifier in your bedroom to alleviate or reduce
nighttime oral dryness |
In addition, avoid
mouthwashes containing alcohol and acidic, carbonated or caffeinated beverages because
these chemicals will dry out your mouth.
Eating with care, adequate nutrition and fluid intake are
important for oral and general health. Occasionally, patients develop nutritional
deficiencies because their mouths are sore from cancer treatment. If your mouth is sore,
choose easy-to-chew foods that are bland in flavor and lukewarm in temperature. Youmay
also want to soften your food with sauces, milk, yogurt or gravy or in a blender to
facilitate swallowing. If your diet is compromised, then consider nutritional or vitamin
Protecting Enamel- If a dry mouth or vomiting is a
side effect of your cancer treatment, your periodontist or dental professional can
prescribe fluoride trays. Use of fluoride trays will prevent the tooth enamel from wearing
away as a result of the gastric acids from vomiting or the increased bacteria as a
consequence from a dry mouth. Rinsing your mouth after vomiting with 1/4 teaspoon of
baking soda in 1 cup of warm water will also cleanse your teeth and gums of the gastric
acids. If you are experiencing vomiting, you may want to ask your oncologist or
primary care physician to prescribe anti nausea medication during your cancer therapy to
treat the nausea and vomiting.
Follow-Up and Long-Term Care- Relationships with
your periodontist and dental professionals are as important after your cancer therapy as
they are before and during your treatments. These continued relationships will help
you maintain a comfortable, confident smile for years.
Reference: The American Academy of Periodontology- Maintaining Oral Health
During Cancer Therapy. Brochure 2002