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Cancer therapy leads to various side effects, and oral complications are considered to be the most common. Oral cavity has one of the fastest growing mucosal tissue in the human body. Cancer in itself is an immunosuppressive condition with the treatment, including chemotherapy and radiation therapy, targeting the rapidly growing tissues, which collaterally damages the oral mucosa and the salivary glands.

When the oral mucosa is affected, the resultant complications include mouth sores, sore throat, dry mouth, infections of the oral cavity, bleeding from the gums, pain while opening mouth and chewing, and few others. The saliva looses its basic protective properties due to the damage to the salivary glands. Saliva contains the enzymes that protect the teeth from tooth decay caused by the oral bacteria. Saliva also helps in buffering and neutralizing the oral acids, which otherwise cause cavities. Therefore, good maintenance of the oral environment is required and is beneficial as well.

Oral complications occur due to chemotherapy as well as radiation therapy. The cancer treatments are stomatotoxic, considering their lethal effects on the oral mucosa. The common oral complications are enlisted below.

Oral mucositis: inflammation of the oral mucosa resulting in pain and nutritional deficiency
Xerostomia: dry mouth as a result of thick, decreased or absent salivary flow; increased risk of infection; compromised speaking, swallowing and chewing ability; taste disturbances (metallic taste)
Abnormal dental development: in pediatrics, reduced or altered tooth growth and discolouration of the teeth, is observed
Bleeding: due to decreased blood cell counts, platelets and clotting factors.
Trismus: loss of elasticity of masticatory muscles leading to insufficient mouth opening

Pre-Treatment Oral Care – Benefits

A dental checkup before the commencement of the cancer therapy helps in resolving existing dental problems and prevent further complications.

  • Effective preventive measures prior to the start of the cancer treatment enhances the success of the treatment regimen, with reduced oral complications
  • Potentiates the identification and treatment of existing infections
  • Oral pain can be prevented or treated, which in turn can prevent nutritional deficiencies
  • Improvement in the oral health as well the quality of life
  • Better medication adherence by the patients

Ways to protect oral cavity during the cancer treatment

  • Brush often, gently
  • Use extra-soft toothbrush; soften the bristles in warm water before brushing
  • Brush after every meal
  • Floss once daily to remove plaque, avoid flossing of the bleeding gums
  • Sip water frequently and rinse mouth with water often, to keep it moist
  • Keep away alcohol containing mouthwashes
  • Restrain from spicy, sour, or crunchy food, and eat easy-to-chew food
  • Consume warm fluids or warm food, instead of hot or cold ones
  • Stop or avoid alcoholic drinks, smoking and chewing tobacco
  • To prevent stiff chewing muscles, open and close your mouth as much as you can, thrice every day. Repeat 20 times

Warning signs to look out for during the cancer treatment

Compromised oral health can be identified by some of the warning signs that occur in the oral cavity. Timely evaluation and treatment of these effects can prevent further complications and mental stress.

  • Mouth sores
  • Swelling of the oral mucosa
  • Bleeding from the gums
  • Mild/Moderate/Severe pain of the mouth or a toothache
  • Appearance of sticky white film
  • Stay Healthy, Stay Happy!

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