"The drugs used to treat cancer, known as chemotherapeutic agents, besides destroying cancer cells, injure normal cells of the body, including those of the oral cavity. "
These drugs produce side effects on the gums, teeth, salivary glands and soft tissues of the mouth. Patients who undergo chemotherapy may have symptoms such as pain in the gums, difficulty eating and speaking, dry mouth, burning and swelling of the tongue and changes in the sense of taste. Additionally, these medications lower the body’s defenses and increase the predisposition to infections by viruses, bacteria or fungi. In some cases, the symptoms can be so severe that it is necessary to discontinue the treatment.
When oral hygiene is poor, the incidence of these complications is much higher. Early detection of oral lesions and stabilization of oral health is very important before starting cancer treatment. Ideally, the patient should be evaluated by a team specialized in oral oncology, if possible a month before starting chemotherapy. Good communication is essential between treating physicians and the dentist, so that they jointly develop a comprehensive plan of care that includes the treatment of mucosal lesions, caries, periodontal disease, alterations in saliva, and if necessary, the correction of badly adapted prostheses and crowns and the treatment of ducts.
Preventive measures include adequate nutrition and good oral hygiene. It is advisable to use a soft brush and floss, and rinse with ¼ teaspoon of baking soda and ¼ teaspoon of salt dissolved in one liter of water. It is recommended to drink plenty of water in order to keep the mouth moist, eat soft foods such as cereals, purées, scrambled eggs and soups, and chew them slowly. The use of toothpicks, the consumption of acidic, spicy, hard, crunchy, or very hot foods, as well as alcohol and tobacco should be avoided. It is also not recommended to ingest sugar, since it can generate tooth decay. If the patient has any symptoms, they should notify the dentist immediately.
When invasive treatments are required, such as dental extractions, it is advisable that the patient receives preventive antibiotics, especially if they have a central venous catheter, in order to avoid the risk of infections and possible bacterial endocarditis.