Life After Cancer: Oral Health Problems

Cancer treatment often causes mouth problems—it affects your oral health. It can cause things like sores, pain, infection, saliva changes, and dry mouth. These can then lead to dehydration and nutrition problems.

Chemotherapy can cause problems in the mouth, no matter what kind of cancer it's used to treat. Radiation treatment to any part of the head and neck can cause problems, too. Some problems get better over time after treatment ends, but some can last for a long time, or even the rest of your life.

Good oral health is important to your overall health and quality of life. It's a key part of your survivorship care plan. But many people don't have dental coverage, and dental care is expensive. Talk with your cancer care team about resources that you can look into.

After cancer treatment, you may have some of these problems:

• Sore, red, and inflamed areas inside the mouth (called oral mucositis)
• Infection from viruses, bacteria, or fungi
• Salivary glands that don't make enough saliva
• Thick, sticky saliva
• Dry mouth
• Pain when chewing, speaking, or swallowing
• Changes in the way foods taste and smell
• Trouble with very hot foods, cold foods, or both
• Cavities, tooth loss, or both
• Peeling or burning of your tongue
• Higher risk of gum disease
• Stiff jaw muscles
• Death of bone in the jaw (called osteonecrosis)
• Nerve pain that feels like a toothache
• Bleeding
• Thinned tooth enamel from vomiting
• Long-lasting (chronic) sores, blisters, and white patches after stem cell transplant (This might be called oral chronic graft-versus-host disease or oral GVHD.)

Make sure to tell all your dental care providers about your cancer treatment. This helps them plan any treatments you might need in the future. They'll be careful around any problems in your mouth and watch for changes. They can also look for signs of new problems. Many times, they can help manage any long-term problems you have.

Tell them if you had chemotherapy, radiation, immunotherapy, targeted therapy, or a stem cell transplant. Also discuss any medicines you're taking, such as those that affect bones. It may help to share your cancer treatment records with them. Each kind of treatment can cause different problems. For instance, radiation can cause dry mouth, cavities, and tooth loss. This could lead to even more problems if you need to have oral surgery or teeth removed later on.

There are simple things you can do to help keep your mouth and teeth healthy. Be sure to:

• Keep regular appointments with your dentist as often as recommended.
• Gently brush your teeth, gums, and tongue with a soft toothbrush after every meal and at bedtime.
• Gently floss between teeth. Stay away from areas that are painful or bleeding. Check with your cancer doctor to be sure it's safe to floss.
• Don't use toothpicks.
• Use a daily fluoride gel or rinse if your dentist prescribes it.
• Don't use mouthwash that has alcohol in it.
• Don't smoke or chew tobacco.
• Use a mouth-moistening rinse or spray to help keep your mouth moist.
• Chew sugar-free gum or suck on sugar-free candy or lozenges.
• Exercise your jaw. Gently open and close your mouth 20 times, 3 times a day to help prevent stiff jaw muscles. Your dentist can teach you exercises that can help with pain and stiffness.

If you have pain or damage to your mouth or teeth, or have a high risk for cavities:

• Eat soft foods, or foods moistened with sauce or liquid to make it easier to swallow.
• Take small bites and chew slowly.
• Don't eat salty, spicy, or acidic foods.
• Don't eat sharp, sticky, or rough foods.
• Stay away from sugary foods, drinks, and gum or candy that has sugar.
• Don't drink alcohol.

After cancer treatment, you may have a high risk for cavities for the rest of your life. Talk with your cancer doctor and your dentist to find out what you can do to take care of your mouth. Make sure to see your dentist regularly. Tell your dentist about any new problems so they can be treated right away.