Nausea, fatigue, and mouth pain … the lions and tigers and bears in chemoland. This article will cover the last of these challenges— mouth pain and the whole oral care issue—when you’re in treatment. Nearly half of survivors who undergo chemo and or radiation deal with oral problems; it happens to almost all head and neck cancer patients as well as those who have bone marrow transplants. Some of us have troubles so bad that it hurts to swallow or even talk.  Here’s some of why it happens and what you can do to keep your teeth and mouth healthy during and after treatments.

 

What’s the connection between treatment and oral problems?

Chemotherapy goes after all rapidly dividing cells, the good and the bad ones. Cells in our mouths are among the most rapidly dividing ones. So you may have problems with your teeth and gums; moist lining of your mouth; and glands that make saliva. The consequences?  Pain (from inflammation), dry mouth (from reduced saliva), changes in taste known to some as “metal mouth” (from irritated taste buds). And there are the lovely mouth sores.

 

How long can this last?

In patients receiving chemo, mucositis (inflammation of mucous membranes in the mouth) typically heals on its own within 2 to 4 weeks. Mucositis from radiation may last 6 to 8 weeks.

 

Bonuses of seeing a dentist ideally before, but at least during, treatment:

You’ll increase your chance of being able to stay on track with your treatment regimen. You’ll likely bypass dehydration; malnutrition; gum infections; and later, tooth decay from accruing bacteria and chemo’s harshness. And foods, well some of us still deal with metal mouth, but at least what you eat will taste closer to what it’s supposed to; and there’s a chance you’ll  nip this annoyance in the bud altogether. Also if you have dentures, this is the time to make sure they fit well for smoother sailing through treatments.

 

What you can do on your own (recommendations of the National Cancer Institute):

Routine care

• Clean the mouth after eating

• Brush with a soft bristle brush 2 to 3 times daily for 2 to 3 minutes. Brush where the teeth meet the gums and rinse often

• Use a foam brush only if a bristle brush cannot be used and use an antibacterial rinse

• Rinse the toothbrush in hot water often to soften the bristles, if needed

• Use a mild-tasting, fluoride toothpaste; flavoring may be irritating

 

Rinsing

• One of the following rinses may be used:

•      1 teaspoon of salt in 4 cups of water

•      1 teaspoon of baking soda in 1 cup of water  
  
• ½ teaspoon salt and 2 tablespoons baking soda in 4 cups of water

• An antibacterial rinse may be used 2 to 4 times daily for gum disease. Rinse for 1 to 2 minutes

• If dry mouth occurs, brushing more often and flossing (once daily) may be needed

  

Lip care

• Use lip care products to prevent drying and cracking

• For special oral care during high-dose chemotherapy and stem cell transplant: Management of Oral Complications of High-Dose Chemotherapy and/or Stem Cell Transplant  

 

About eating and drinking

• Drink a lot of water and suck on ice chips (especially helpful while you’re getting chemo)

• Lay low on gum and hard candies, especially with sugar

• Take a break from spicy or acidic foods like citrus fruits and juices

• Eat soft foods, and if you still have trouble swallowing, soften your food with yogurt, gravy, broth, or other liquids

• Sip liquids with your meals so food slides down easier

 

About mouthwashes

Mouthwash helps with pain and inflammation. But skip the ones containing alcohol. And if store-bought mouthwashes don’t work, you may want to ask your doctor about bringing out the big guns. There are prescriptions, like magic mouthwash (First-Mouthwash BLM, First-BXN Mouthwash, others). Magic mouthwash usually contains at least three of these ingredients:  An antibiotic, antihistamine or local anesthetic for pain, corticosteroid for inflammation.

There’s’ a fairly new prescription drug called Caphosol (generic name: artificial saliva solution). You may want to read up on it and ask your doctor about.

 

More on managing oral problems from treatment

http://www.cancer.gov/cancertopics/pdq/supportivecare/oralcomplications/Patient/page5

 

Resources that may offer or lead you to financial help with dental care

http://www.govbenefits.gov

http://www.copays.org/about_cpr.php

http://www.cancercare.org/financial

http://www.cancerfac.org/

 

Referring source for breast cancer survivors

http://www.smilesforsurvivors.org/about