Think Before You Brush: Dental Hygiene After Vomiting

Vomiting is a common side effect of many cancer treatments and can lead to dental decay. However, there are steps that patients can take after throwing up to protect their teeth, explained Patricia Mulvaney-Roth, a nurse and lead clinical educator at Molloy College.

“Dental erosion is a complex clinical condition that is not well-known by lay people or by non-dental health professionals,” Mulvaney-Roth said, explaining that erosion occurs when dental hard tissue erodes.

Erosion can happen as a result of drinking excess soft drinks or alcohol, or by the mixing of hydrochloric acid from gastric juices formed by the stomach lining – what happens when a person vomits.

Mulvaney-Roth and her team recently reviewed 14 studies regarding vomiting-related dental erosion and presented their findings at the Oncology Nursing Society (ONS) Bridge virtual conference. Notably, four studies outlined the benefit of rinsing with water or saltwater after a vomiting episode and five studies said that commercial mouthwashes containing fluoride can help.

Additionally, many patients may want to brush their teeth soon after throwing up. However, that, too can lead to dental erosion because teeth are softest for the hour after vomiting.

“[There are] some important things to look at here. A patient’s own oral hygiene self-care can mistakenly worsen dental erosion, tooth sensitivity and tooth breakage, because they’re running to brush their teeth after a vomiting episode,” Mulvaney-Roth said.

“If dental erosion is left unchecked, certain cancer patients who survived the cancer illness phase can eventually suffer long-term mandibular and maxillary problems. Once lost, enamel cannot be replaced.”

Mulvaney-Roth emphasized that both patients and health care providers need to be better educated on dental health, especially for patients with cancer who may be prone to vomiting as a result of their cancer treatment.

“Patient education should include [discussing] rinsing your mouth with plain water, a salt mixture, or mouthwash with fluoride after vomiting to reduce dental erosion. Using a tongue cleaner is recommended after the vomiting to remove the acid from the tongue.”