Cancer treatments can have a wide-reaching effect on the body, including your mouth. If you have been diagnosed with any form of cancer, you’ll be glad to know there are steps you can take to protect your teeth and gums during treatment. (If you are searching for information on cancers that start in the mouth or throat, visit this page.)
No matter what kind of cancer you have, here’s what to expect at each stage of cancer treatment and how to safeguard your dental health.
How cancer treatment can affect your mouth
Chemotherapy and radiation are designed to fight fast-growing cancer cells, but they may affect normal cells, as well as just the cancer itself. This can reduce your body’s ability to fight infection. So for example, tender gums might turn into early-stage gum disease (gingivitis), or you may develop mouth sores or ulcers.
Chemotherapy can affect healthy cells that grow quickly, including the cells that line your mouth. This might cause dry mouth, changes in taste, or a burning, peeling or swollen tongue.
Dry mouth can also be caused by radiation therapy of the head or neck, since this treatment can damage the glands that make saliva. Head and neck radiation can also trigger mouth sores, infections, and pain or stiffness in your jaw bones.
Side effects like these can make it hard for you to eat, talk or swallow, which can compromise healing and your quality of life. That’s why working closely with your dentist and cancer treatment team to address these issues is so important.
Start a healthy dental routine before cancer treatment starts
Infections and other dental issues can actually cause delays in cancer treatment, so it’s good to do everything you can to prevent problems. In fact, the National Cancer Institute (NCI) recommends that dentists be seen as part of the cancer care team. Here are the steps you should take before cancer treatment begins.
Visit your dentist. The NCI recommends a dental checkup at least four weeks before you start treatment. Let your dentist know about your diagnosis and ask if there are any issues that should be dealt with before treatment begins. For example, your dentist might recommend fluoride treatments to prevent tooth decay, filling existing cavities, treating gum disease, removing infected teeth or restoring crowns or bridges. If you don’t have a regular dentist, the ADA’s Find-a-Dentist tool can help you connect with dentists near you.
Brush and clean between your teeth daily. Adults should brush twice a day for two minutes each time (morning and bedtime are best). Be sure to brush your tongue, too. Gently clean between your teeth once daily to remove any sticky buildup (plaque).
Don’t use tobacco. Smoking and smokeless forms of tobacco (including vaping) can be hard on your body, especially your mouth. And while it’s hard to cut back or quit, this step can help your body heal faster. Find real-world advice for quitting here.
Rethink what you eat. Choosing a diet rich in fruits, vegetables, lean proteins and grains will give your immune system a real boost. For now, you may want to reduce citrus fruits and other high-acid foods and drinks that are hard on tooth enamel. Drink plenty of fluoridated water for a cavity-fighting boost. To explore food choices based on your age, cultural preferences, budget and more, visit MyPlate.gov, where you’ll find an easy-to-use tool for creating a personalized eating plan.
Rinse your mouth often. Cleansing your mouth keeps leftover food away from your teeth and gums, which can reduce your risks for tooth decay and infection. Avoid mouth rinses with alcohol, since they may be too harsh. Here are rinse solutions you can make at home:
- 1 teaspoon salt dissolved in 4 cups water
- 1 teaspoon baking soda dissolved in 1 cup water
- ½ teaspoon salt and 2 tablespoons baking soda in 4 cups water
Special concerns during cancer treatment
Radiation and chemotherapy may trigger more serious dental problems, so keep following the healthy routine you started before treatment. You should also:
Rinse more often to ease the effects of dry mouth, which can open the door to tooth decay.
If you vomit during or after treatment, rinse your mouth first, then wait at least 30 minutes to brush. Rinsing swishes stomach acids away from tooth surfaces, preventing damage to your tooth enamel.
Talk to your cancer care team before visiting the dentist. If you are taking special medications to prevent blood clotting, your dentist will need to know this. These medications are often given to patients with a port under their skin. Ask your care team for tips in coordinating with your dentist.
Ask about gentle tools and techniques for cleaning your teeth if your mouth is especially sore. Your dentist might recommend an extra-soft toothbrush and special flossing aids. You can soak your toothbrush in warm water to soften the bristles even more. If your gums are tender or bleeding, skip the trouble spots, but continue to gently clean between the rest of your teeth to keep them healthy.
When treatment ends, keep up your dental care routine
After cancer treatment, your body will need time to recover. Schedule a checkup with your dentist to make sure that any sores or infections that flared up earlier are healing well.
If you postponed certain dental treatments during chemotherapy or radiation, talk about scheduling them now. You may need time to rest and recover before any major procedure. Your dentist will let you know of any urgent issues and recommend a plan to deal with them.
Brushing, flossing, eating a healthy diet and avoiding tobacco are all steps you should continue after you are done with cancer treatment. Not only do they support good dental health, but they’re solid steps in keeping cancer away for good. Learn more about dental health and cancer prevention here.
More resources for you
From the American Cancer Society: more ways to relieve dry mouth and painful mouth sores caused by cancer treatment.
Explore free tools to help you quit smoking.
Why sipping on plain water is so good for your teeth and gums.