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June 7, 2010 in Dentistry by McCarl Dental Group

Visit your dentist at McCarl Dental Group several weeks before starting chemotherapy or radiation therapy to check for bacterial infections, such as nerve abscesses, periodontal disease or plaque build-up on your teeth.  Although chemotherapy is given to kill cancer cells, it can also damage normal cells. Especially rapidly growing cells like those found in the mucosal lining of the mouth and throat. Chemotherapy may compromise your immune system by lowering the number of white blood cells produced in your body. This may place you at a higher risk for developing infections, and your body may be less able to fight infections once they develop. An oral infection can travel through your bloodstream and have very serious consequences if it occurs when your immune system is suppressed.

Your dentist is an important member of the health care team during your cancer treatment. Visit your dentist before chemotherapy begins to make sure your mouth is healthy. Your Millersville and Greenbelt Dentists and Hygienists at McCarl Dental Group will examine and clean your teeth, take necessary x-rays, identify and address any dental problems or concerns and teach you how to care for your mouth during cancer treatment. Not all mouth changes and problems can be avoided but you may be able to decrease or minimize side effects.

It is not uncommon for chemotherapy and radiation therapy to cause inflammation of the mucous membranes lining the mouth and upper gastrointestinal tract. This inflammation is called mucositis and sometimes causes soreness in the mouth, gums, and throat. Patients may also experience red burn-like sores or ulcers throughout the mouth which can cause discomfort and interfere with eating, taste, chewing or swallowing and can affect appetite, weight and nutritional status.

In addition to sores in the tissues lining the mouth and throat, other problems associated with chemotherapy and radiation therapy include dry mouth (little or no saliva), changes in taste and smell (food may taste like metal, have no taste, or may not taste or smell like it used to), increased risk of infections of your gums, teeth, or tonsils, and increased sensitivity to hot or cold foods. The severity of side effects varies greatly from one person to another.

Dry mouth is a common side effect of chemotherapy and radiation therapy. One of the concerns about dry mouth is that it increases likelihood of cavities and tooth decay. Saliva is a buffering agent that reduces acids. Dental plaque is a sticky film of bacteria that forms around your teeth and on your gums. It is important to brush teeth twice daily and floss daily to help remove plaque. Without routine brushing and flossing, plaque can harden within 24 hours, requiring professional cleaning for removal. The bacteria in plaque that normally accumulates on our teeth turns sugars in our mouths into acid. Acid eats holes in the enamel of the teeth causing cavities. Using saliva substitute when your mouth feels dry will help keep your mouth moist and with routine brushing and flossing may help prevent tooth decay.
Biotene makes several excellent oral moisturizer products for dry mouth. It is also important to keep your mouth and lips moist by drinking plenty of liquids. Sip water through a straw, suck on ice chips and use lip moisturizer.

Brush your teeth and tongue with a very soft toothbrush after every meal and at bedtime with toothpaste that contains fluoride. Every three hours during the day rinse your mouth with the following mix (1 cup warm water, ¼ teaspoon baking soda and 1/8 teaspoon salt). This mouthwash can soothe pain and dislodge food particles to help avoid infection. Oral hygiene is the mainstay of prevention and treatment of mouth and throat discomfort and will also help prevent infections!

What Foods Should I Eat?
Maintain a balanced diet and include foods from the five different foods groups – grains, fruits and vegetables, dairy, and meats or other protein sources. It is important to eat a varied assortment of healthy foods, emphasizing plant sources.

If your mouth is sore, eat soft, bland foods that are moist and easy to swallow (good choices include scrambled eggs, cooked cereals, custards and mashed potatoes). Liquid supplements including Instant Breakfast, Ensure, and Boost can also provide nutrients without discomfort. You may want to soften foods with gravy or other liquids.

Avoid things that can make your mouth hurt!
•    Don’t use mouthwash containing alcohol.
•    Avoid alcohol, such as beer and wine and liquid medications containing alcohol (some cough medicines).
•    Don’t drink citrus beverages including orange, lemon, tomato or grapefruit juice.
•    Don’t eat foods that are very hot or very cold, crunchy or spicy.
•    Minimize sugary foods and soft drinks.
•    Do not smoke cigarettes or use other tobacco products.

The goals of treating mouth and throat changes are to decrease the severity and shorten the duration of inflammation, to provide relief from discomfort, and prevent or treat infection. Ask about pain medicine or medicated mouthwash to reduce discomfort if your mouth or throat is sore.

When to Call your Doctor or Nurse
•    Temperature is greater than 100.5 F.
•    If you have difficulty eating or swallowing, white patches in your mouth or sores on your lips or in your mouth.
•    Also let your nurse know if you experience changes in taste or smell, dry mouth, or pain when you eat hot or cold foods.

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8601 Veterans Hwy, Suite 101, Millersville, MD 21108 USA
Dr. Clayton McCarl, Jr. Millersville, MD cosmetic, restorative, & preventive dentistry.
28 Ridge Road, Greenbelt, MD 20770 USA
Dr. Clayton McCarl, Jr. Greenbelt, MD cosmetic, restorative, & preventive dentistry. (301) 474-4144