Elsevier

Dental Abstracts

Volume 59, Issue 4, July–August 2014, Pages e87-e88
Dental Abstracts

Hands On
Oral effects of cancer treatment

https://doi.org/10.1016/j.denabs.2014.03.030Get rights and content

Section snippets

Background

Cancer chemotherapy and adjunctive therapies come with oral side effects that can be distressing to patients. Dental professionals should be aware of the drugs and procedures used to manage cancer and their side effects, be able to educate patients about these effects, and help to reduce side effects when possible.

Osteonecrosis

Intravenous (IV) bisphosphonates are given to cancer patients to increase bone density and reduce the risk of fractures, but can also lead to osteonecrosis of the jaw. In this complication the bone is exposed in either the maxilla or mandible and does not heal. Osteonecrosis manifests with localized pain, soft tissue swelling and inflammation, mobility of teeth that had been stable, drainage, and exposed bone. These often develop at the site of previous extractions or other dental surgeries.

Drug Side Effects

Chemotherapeutic medications must be thoroughly researched so the dental professional can advise patients about the possible side effects. Among these are hypersensitivity, discomfort and pain, ulcerated gingival tissues, and impaired taste buds (Table 2). If the patient develops vomiting after chemotherapy is given, the teeth can suffer enamel erosion, which can lead to tooth sensitivity. After vomiting, the patient should rinse with lukewarm water and dissolved backing soda or salt before

Mucositis

Chemotherapeutic agents can also produce ulceration of the mucosa lining the digestive tract, which includes the oral cavity, leading to morbidity in patients. Oral and gastrointestinal mucositis may occur in up to 100% of all patients receiving high-dose chemotherapy with hematopoietic stem cell transplantation (HSCT). Oral mucositis can manifest as anything from mild inflammation and redness of the mucosa to severe ulceration. Pain and discomfort can make the patient unable to eat or drink,

Oral Care Guidelines

The dental hygienist should schedule dental hygiene care for right before the patient receives the next chemotherapy treatment to maximize the patient’s ability to handle the treatment. A consultation with the patient’s oncologist can reveal when the patient’s blood count is optimal so platelets can facilitate blood clotting and neutrophil count is sufficient. Treatment is most effective when the patient has the highest possible level of formed blood elements, which protects against infection.

References (0)

Cited by (0)

Swartzentruber L, Haveles EB: Oral health care during chemotherapy. Dent Econ 103:75-79, 2013

Reprints available from EB Haveles; e-mail: [email protected]

View full text