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How to Maintain Good Oral Health

A few precautions and choices can help avoid major complications during and post treatment.

More than 30-35% of patients undergoing cancer treatment will suffer from oral complications. -

Regardless of the type of cancer you have (breast, lung, prostate, colon, esophageal, gastric, etc.) maintaining good oral health goes a long way in easing your treatment journey and supporting your body as it constantly adjusts to your new state based on the types of treatment you undergo.

The oral cavity or mouth is all about balance.

A healthy mouth is a balance of saliva flow and consistency, bacteria, diet, cleanliness and minimal plaque. Cancer treatment and its associated therapies like chemotherapy and radiation, can disturb this balance and cause complications that might interfere with the treatment and affect quality of life. Hence, a visit to the dentist should be on your list of things to do before starting your cancer treatment. You will want to have your dentist to thoroughly evaluate and treat any potential problem areas prior to starting your cancer treatment. You will also want a thorough cleaning and fluoride treatment and schedule more frequent recall appointments.

Establishing an optimal oral care routine and being prepared with knowledge and products to help deal with side effects of treatment is important. Too many patients wind up with complications ultimately leading to tooth loss. Your dentist can help you maintain tooth structure and keep you comfortable through treatment. He or she will make treatment recommendations based on your caries risk assessment as well as type of cancer and cancer treatment. Delaying dental treatment and leaving problem areas may result in a delay of cancer treatment in the future.

The American Dental Association lists the following common oral side effects from cancer treatment:

  • Cavities, also known as caries

  • Changes in taste

  • Dry mouth

  • Jaw stiffness

  • Oral sores or mucositis.

These side effects may result in difficulty in eating, talking, or swallowing. The changes in your immune response will also make it harder to fight oral infections. Your dentist will recommend a preventative protocol and help you with deciding which products can help alleviate these side effects.

Here are some recommendations:

  • Cavities risk is decreased by brushing with a fluoride or hydroxyapatite toothpaste at least twice a day.

  • Flossing will reduce your chances of developing cavities on the interproximal surfaces or in between your teeth.

  • Avoid foods and drinks that are high in sugar.

  • Sugar free candies or chews, especially those made with Xylitol will help stimulate saliva flow. Not only does the flavor stimulate saliva flow but just chewing does as well.

  • Limiting refined sugars as well as the length of exposure to sugary foods is important. You are at more risk of developing decay if you have a piece of candy or sugary gum in your mouth all day versus eating it all at once and then drinking water. The combination of a sugary diet and bacteria leads to a lower pH or acidic environment in the mouth which demineralizes the enamel.

  • Keeping your oral cavity hydrated and reducing dry mouth will help bathe the teeth and help fight decay.

  • Mouth rinses such as salt and baking soda mixes help keep the oral tissues moist and help combat the development of oral ulcerations. A basic pH mouth rinse (such as a Xylitol or fluoride rinse) neutralizes the pH and can even help remineralize a person's enamel.

  • You will want to get a super soft toothbrush especially when your oral mucosa is irritated.

  • A visit to your dentist every 3 months for an exam and for any personalized treatment based on your oral health is very effective in prevention of complications later.

As always, make sure your cancer care team and your dentist are communicating with each other regularly to optimize your care. Take charge of your oral health to assist your body as it adapts to your cancer treatment.

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Reason to Hope

There is new research from Brigham and Women’s Hospital that indicates a Western-style diet that is rich in red and processed meat, sugar and refined grains/carbohydrates is tied to higher risk of colorectal cancer through the intestinal microbiota.  Gastroenterology, 2022;DOI:10.1053/j.gastro.2022.06.054 

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