With more than a million cases of cancer diagnosed every year, it is very likely that you’ll encounter some cancer patients in your practice. The treatment received by these patients can affect all tissues in the body, including oral tissues; thus, the risk of oral side effects are high.
Most of these side effects can affect the patient’s quality of life, sometimes so debilitating that it causes them to tolerate only lower doses of the therapy, reschedule treatment, or stop treatment altogether. Below is a list of oral side effects common to the two most common cancer treatments – chemotherapy and radiation therapy – along with complications specific to each one and oral surgery & root canals can also help you.
Oral Complications of Chemotherapy
The two most common side effects of chemotherapy alone are bleeding and neurotoxicity. Bleeding is due to decreased amount of platelets and clotting factors, both of which result from bone marrow depression.
Neurotoxicity, on the other hand, pertains to a persistent, deep burning pain that mimics a toothache but the source cannot be found or identified. This side effect is observed mostly in a group of drugs known as vinca alkaloids.
Oral Complications of Radiotherapy
Radiotherapy, meanwhile, causes side effects like radiation caries, trismus, tissue fibrosis, and osteonecrosis. Radiation caries may start to develop and show up within three months of completing radiotherapy.
It is most often due to change in the quality and/or quantity of saliva. Tissue fibrosis and trismus, on the other hand, are related since fibrosis results to loss of elasticity of the jaw muscles which in turn limits the ability to open the mouth.
Osteoradionecrosis or bone tissue death is one of the worst adverse effects of radiotherapy. It occurs as a result compromised blood supply and the poor healing ability of traumatized bone. It is often observed in patients who receive high doses of radiotherapy.
Oral Complications of Chemotherapy and Radiotherapy
Needless to say, if chemotherapy and radiotherapy are combined, there will be even more side effects, but not necessarily worse. Not all of these side effects are as serious as the ones we’ve discussed above.
Some of the relatively less serious side effects include oral mucositis, xerostomia (dry mouth), taste alterations, abnormal tooth development, and infection.
Oral mucositis refers to the ulceration of the mucous membranes. It can sometimes lead to ulcerations which, in turn, can cause pain, infection, and compromised nutrition.
Xerostomia, on the other hand, pertains to reduced, thickened, or totally absent salivary flow. With decreased saliva, one’s risk for dental caries and other oral infections is increased. It can also lead to difficulty in speaking, chewing, and swallowing.
Taste alterations cause a change in the perception of taste. It ranges from unpleasant taste to complete loss of taste. Abnormal tooth development, meanwhile, occurs when the patient is subject to high-dose radiotherapy and chemotherapy before the age of nine.
Lastly, infection results from bone marrow depression and, as previously mentioned, from oral mucositis and xerostomia.
Thus, oral health care in San Diego prior, during, and following the treatment is important to help prevent or at least reduce these complications. By consulting your dentist, identification of existing oral health problems can be identified and managed promptly, allowing you to complete your cancer treatment and get the most out of it.