Brush Up on Oral Hygiene After Cancer

Cancer survivors can face many side effects from treatment; unfortunately, some are not manageable. However, others, such as dry mouth, can be counteracted by practicing good oral hygiene.

Heal® spoke with Dr. David R. Dean, director of oral medicine at the Fred Hutchinson Cancer Center in Seattle, about risk factors for developing oral problems, effect on quality of life and what cancer survivors can do.

Risk Factors and Side Effects

Developing oral side effects is extremely common in some types of cancer, specifically head and neck cancers. The radia- tion levels are so intense that damage to salivary glands (which produce saliva that aids digestion, keeps the mouth moist and supports healthy teeth) can result, Dean explained.

Survivors with certain immune-related issues from cancer therapy also can be at risk for oral side effects. This includes those who have had a bone marrow transplant or peripheral blood stem cell transplant and may develop graft versus host disease (a condition that occurs when donor bone marrow or stem cells attack the recipient), which can also affect the salivary glands.

Immunotherapy and chemotherapy also may cause oral side effects in survivorship.

Dean noted that the most common oral side effect cancer survivors experience is dry mouth. This can greatly affect quality of life because survivors can find it hard to talk and socialize. Eating may become difficult as well, so some individuals may lack the nutrition they need.

“The dry mouth issue, which is probably the one that comes up the most often for people, affects quality of life because just in general the mouth is less comfortable — it can make it more challenging to speak, eat and swallow,” he explained. Decreased saliva also increases risk for cavities which can lead to pain, increased need for dental work or even loss of teeth. “It’s just one more thing on top of every other aspect of survivorship, which can be pretty tough,” Dean added.

The Importance

If someone has ended treatment or is undergoing treatment through survivorship, maintaining daily oral hygiene can decrease the likelihood of many of these side effects, Dean said.

His top oral hygiene tip is to keep up with daily brushing and flossing; this will help combat dry mouth, and symptoms that come with it such as tooth decay.

Survivors should also have what Dean called a “dental home” — a dentist or clinic they can go to consistently. The dentist should know their cancer and treatment history to personalize treatment for survivors and help them understand risks they face.

A dentist can also help to screen for oral cancer, which can be more likely in survivors of certain cancers, and other late effects of cancer therapy, he added.

“Having somebody who knows your mouth well and can provide a general screening to supplement all the things that the medical team is already doing really helps a lot,” he said.

Dean added that oral hygiene is an area that can be controlled, which is important for cancer survivors to do to avoid pain or discomfort.

“It’s important to try and minimize any pain and suffering related to preventable causes,” he said. “It’s something where there can be some control. (Cancer survivors) feel like they can actively focus on oral hygiene and that it is likely to make a difference, as opposed to something where it’s excessively hard to prevent complication.”

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