The only thing worse than a cancer diagnosis is a late-stage cancer diagnosis. Oral cancer, when caught early has a significantly improved survival rate. That's why we screen for oral cancer at every checkup. We do this for all our patients, but did you know that there is also something that you can do?
Along with regular dental visits, you can also avoid certain risk factors. Two of the biggest risk factors are alcohol consumption and tobacco use. Your chances of oral cancer increase 100 times if you use tobacco and drink heavily!
It is recommended that whenever possible, a pre-therapy dental evaluation with a full set of mouth x-rays be performed. Any decay, gum disease and abscesses should be treated, if time permits, prior to chemotherapy and/or radiation therapy.
Even patients that have no pain or dental disorders need a thorough cleaning. The goal should be to have the patient's mouth in optimal health prior to beginning anti-cancer therapy.
Oral Complications Related to Cancer Treatment
Oral complications of cancer treatment arise in various forms and degrees of severity, depending on the individual and the cancer treatment. Chemotherapy often impairs the function of bone marrow, suppressing the formation of white blood cells, red blood cells, and platelets (myelosuppression). Some cancer treatments are described as stomatotoxic because they have toxic effects on the oral tissues. Following are lists of side effects common to both chemotherapy and radiation therapy, and complications specific to each type of treatment. We will need to consider the possibility of these complications each time we evaluate a patient with cancer.
Oral complications common to both chemotherapy and radiation
- Oral mucositis: inflammation and ulceration of the mucous membranes; can increase the risk for pain, oral and systemic infection, and nutritional compromise.
- Infection: viral, bacterial, and fungal; results from myelosuppression, xerostomia, and/or damage to the mucosa from chemotherapy or radiotherapy.
- Dryness of the mouth: due to thickened, reduced, or absent salivary flow; increases the risk of infection and compromises speaking, chewing, and swallowing. Persistent dry mouth increases the risk for dental caries.
- Functional disabilities: impaired ability to eat, taste, swallow, and speak because of mucositis, dry mouth, trismus, and infection.
- Taste alterations: changes in taste perception of foods, ranging from unpleasant to tasteless.
- Nutritional compromise: poor nutrition from eating difficulties caused by mucositis, dry mouth, dysphagia, and loss of taste.
- Abnormal dental development: altered tooth development, craniofacial growth, or skeletal development in children secondary to radiotherapy and/or high doses of chemotherapy before age 9.
Other complications of chemotherapy
- Neurotoxicity: persistent, deep aching and burning pain that mimics a toothache, but for which no dental or mucosal source can be found. This complication is a side effect of certain classes of drugs, such as the vinca alkaloids.
- Bleeding: oral bleeding from the decreased platelets and clotting factors associated with the effects of therapy on bone marrow.