The Surprising Oral Side Effects of Chemo and How to Fight Back

October 22, 2021
The Surprising Oral Side Effects of Chemo and How to Fight Back

Written by Francine Julius


For those of us new to a diagnosis, the first questions that strike our minds are typical. “What can a cancer patient receiving chemotherapy expect during treatment?” “Will I be able to fare it out?” Of course, there are the standard symptoms of nausea, loss of appetite, and sometimes even weight gain because of steroids.  However, one of the little-known side effects is the potential for deteriorating oral health.

The truth is, many patients with head and neck cancers develop mouth issues after their diagnosis. But people with cancers of all types can suffer from dental mishaps following systemic chemotherapy. These oral and intravenous anti-cancer medications contain chemical agents that may affect your teeth. Although oral treatments for cancer tend to have fewer side effects, it’s still good practice to keep an eye out for any changes.  It’s not that dental problems are inevitable, but most people only learn about them when they’re well into chemotherapy. 

Cancer is hard enough; your teeth should not be another sad story. We can change that. In this read, we’ll discuss the importance of maintaining good oral health and how it can help you receive the best treatment for your cancer. 

Why Oral Health Matters

A healthy smile is a powerful asset to your self-confidence. Reports show that persons who maintain positive body images throughout their journey have better treatment outcomes. Yes, it sucks to live with a tumor--not to mention the rigorous regimen that doctors set for your recovery. But being able to laugh through your journey will boost your spirit and that of your loved ones. It’s your ammunition to stay motivated during the highs and lows of your experience.

What Can a Cancer Patient Receiving Chemotherapy Expect During Treatment?

Not all patients will exhibit the same signs and symptoms during their treatment. Your experience depends on factors like age, sex, the size and location of your tumor, and your treatment plan. However, there are common triggers that could aggravate your oral health during your rounds of therapy.

  • Frequent vomiting: Acids coming up from your stomach may settle on your teeth and gums. Persistent throwing up can erode your enamel and leave you with a chronic sore throat. As your tooth structure weakens, you’ll also be at a greater risk of developing cavities or losing teeth.

  • Jaw pain: Oral treatment for cancer tends to have fewer nausea-related complaints from patients but can lead to issues with neuropathy. Munching, brushing, and flossing all become a pain from the nerve damage along your lower jaw.

  • Facial numbness: Neuropathy can also cause patients to lose sensation in their facial muscles and develop drooping faces. This also makes it difficult for patients to chew solid foods - a significant source of nutrition during recovery. 
  • Mouth blisters and thick saliva: According to the American Cancer Society, chemotherapy is “the most common cause of a weakened immune system in people getting cancer treatment.” Radiation therapy falls next in line. These treatments are notorious for causing mouth sores and reducing saliva production, which is critical for preventing plaque buildup. As a result, cancer patients are at higher risk of oral infections, gum disease, and yeast overgrowth. 

Do Systemic Chemotherapy and Radiation Have the Same Effects?

“Patients with head and neck cancers often receive radiation therapy as part of their treatment,” says Dr. Miriam A. Knoll, MD., a radiation oncologist at Montefiore Nyack Hospital. Chemoradiation - a combination of IV or oral treatments for cancer and radiation therapy - may reduce the spread of the disease. 

One of the long-term side effects of systemic radiation is the stiffening of the jaw. Knoll also adds that “the mandible may receive radiation, and this can weaken the bone.” 

Fortunately, you’ll be able to mitigate many of these effects with the right approach to your cancer diagnosis.

What You Can Do About It

It can be challenging to find the light at the end of a tumor. Many people wonder if their life after cancer will ever be the same. But rest assured, you’re not helpless in this battle. There are practical steps that you can take to improve your treatment and increase your chances of walking away with a grin.

Systemic chemotherapy tends to worsen pre-existing dental conditions. The safest route is to visit your dentist a couple of weeks before beginning your course of drugs. And, of course, keep them up to speed with your diagnosis. Your transparency will help them evaluate your current health status and create a treatment plan to suit your regimen. 

You should request a complete oral check to rule out any lingering cavities, broken teeth, or inflammation. These should all be rectified before your therapy session to reduce your chances of oral complications.

Aside from an office visit, here are other interventions you can use to save your smile:

  • Using a Waterpik or other water flossing devices to remove debris.
  • Using fluoride toothpaste to support strong enamel.
  • Using a soft toothbrush to avoid scraping inflamed tissue.
  • Avoiding alcohol-based mouthwashes that may sting on oral blisters.
  • Rinsing with warm salt water to flush out vomit (it will also soothe sore gums).
  • Sucking on ice chips to remedy dry mouth and sore gums.
  • Staying hydrated and using xylitol gum to stimulate saliva production.
  • Consulting with a physiotherapist for jaw relaxation exercises.
  • Avoiding crunchy snacks that could bruise your gums or worsen infections.
  • Talking to a dietician about a soft-food, gum-friendly diet.
  • Doing daily oral checks for unusual changes - and informing your dentist.

How You Can Support A Loved One

Cancer is a rapidly debilitating disease. It’s typical for patients to complain of low energy levels especially following exposure to systemic chemotherapy. Feelings of weakness can make daily routines, like brushing and flossing, unimaginably taxing for them. The regular commute to and from doctors’ visits can also add to their demotivation.

Those are the moments when they’ll need you the most - to be a friend, a helper, and a face of hope. It’s crucial that they have some form of social support, especially during their bouts of depression and anxiety. They’ll need someone by their side to encourage them to eat and get moving, despite their loss of appetite and malaise. 

Customarily, you may resort to sweets to help relieve their distress. Everyone needs a Lollie every once in a while - just be sure not to make it a habit. Regulating sugary foods will help reduce their chances of cavities, infections, and tooth loss. Remember, our primary goal is to maintain healthy nutrition for a naturally healthy smile.

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