We may have each encountered a loved one who gets a scary cancer diagnosis that takes us by surprise. Fortunately, with appropriate treatment, more and more patients survive cancer and/or live with it rather than die from it.
Often the complications from cancer treatments affect the mouth. Did you know that the chief complaint for many cancer patients is mouth sores? The most common oral complications related to cancer therapies are mucositis (inflamed mouth or throat linings), infection of the gums or bone, drying of saliva glands, taste dysfunction and nerve damage pain.
Mouth sores (mucocitis and ulcerations) are associated with significant pain, which often interrupts the patient’s ability to eat and compromises the patient’s nutrition. In turn, without proper nutrition healing is interrupted.
How we manage that pain is critically important. Many oncologists prescribe narcotic pain meds because it’s easy. They may not be familiar with appropriate topical (surface) treatments, pain relievers, and analgesics. Your dentist can be an important part of the treatment team. Without topical treatment, the oncologist or cancer treatment center might choose to decrease or interrupt the chemotherapy, which may compromise its effect on the cancer.
Cancer patients often change their food preferences. If a person’s mouth hurts or taste becomes dysfunctional, they eat what they can or they might just stop eating. The calorie deficit causes weight loss. The best thing we can do to facilitate normal eating is treat the patient for discomfort. Again, this calls for a team approach that integrates oral medicine with the planned cancer therapy.
To protect a patient from excessive weight loss, your doctor may recommend a high-calorie supplement such as Boost or Ensure. Unfortunately, these are both filled with sugar, which increases the cavity risk.
For cavity prevention, the first defense is always fluoride! For cancer patients, we can make custom fluoride carriers (similar to a bleach tray) that can be loaded with professional strength fluoride for home treatment.
Also helpful is a therapeutic intake of xylitol, a sweet substance that suppresses acid-production, as well as topical calcium phosphate to help remineralize the enamel surface. There is special toothpaste made by CariFree called CTx4 that has ALL these cavity-fighting components but is only available in dental offices.
Cancer survivorship is growing. This is a different world and it carries over dramatically into oral/dental needs. Be sure to include your dentist in your cancer treatment team.
Susan Maples, DDS, MSBA is a dentist in Holt. She is also a speaker, business consultant, and author. Reach her at firstname.lastname@example.org.