Cancer and Oral Health
Your dentist to perform an oral cancer screening exam at your regular check-up appointment
Your dentist or dental hygienist how best to look after your mouth to avoid oral cancer and other dental diseases
Your dentist and oncologist to communicate with each other over your cancer therapy and oral health
Your dentist if you have been recently diagnosed with cancer and ideally before cancer therapy starts
Contact your dental office if you have any mouth sores that do not go away within 10–14 days or if you notice any lumps or numbness around the mouth
Smoking and smoke-less tobacco and excessive alcohol consumption are major risk factors for oral cancer
To perform a monthly oral cancer self-exam
To take good care of your mouth and teeth when undergoing cancer therapy
Cancer treatments may affect your normal oral health, so it is essential to visit your dentist after being diagnosed with any cancer. By conducting an oral evaluation before the cancer treatment commences, your dentist can identify and treat any problems such as periodontal disease, tooth decay, fractured teeth and restorations, or infections that could contribute to oral complications when the cancer therapy does begin.
Common side effects of cancer treatment like nausea and hair loss are well known. More than one third of people treated for cancer will develop complications that affect the mouth. These complications may interfere with treatment and decrease the patient’s quality of life.
Some cancer therapies, especially those for cancer of the head and neck region, will affect the functioning of the salivary glands and the amount and quality of your saliva. This increases your risk to dental decay, as saliva helps to protect you against dental decay. Your dentist or dental hygienist will be able to recommend how to keep your mouth moist in the absence of a normal saliva flow, as well as the need for any additional fluoride treatments; both daily (at home) and applied in the dental office.
Other complications of both chemotherapy and radiation include:
- Inflammation and ulcerations of the mucous membranes that line the mouth
- Fungal, bacterial, and viral infections
- Altered taste perception ranging from tasteless to unpleasant
- Abnormal dental and facial development and growth in children
You should also take extra care of your teeth and gums during and after cancer therapy. Make sure that you brush at least twice a day with a good quality toothbrush and a fluoride toothpaste; clean between-the-teeth at least once per day. If brushing hurts, try a soft or extra-soft brush and a mild-flavored toothpaste. If using mouth rinses, avoid those that contain alcohol as the astringency of the alcohol may ‘burn.’ Follow the directions provided by your dentist and dental hygienist, and don't forget to ask them if you have any questions or concerns about your oral health and your cancer care. Remember, good oral care during cancer therapy contributes to success.
Cancer is the uncontrollable growth of cells that invade and damage healthy tissue. Oral cancer, also known as mouth cancer, includes all cancers that occur on the lips, cheeks, tongue, floor of mouth, the palate and the throat. The American Cancer Society estimates that in the United States over 41,000 new cases will be diagnosed in 2013 and that over 7,800 deaths will be attributable to oral cancer. When diagnosed at an early stage of development, the survival rate for oral cancer is as high as 80-90%. Unfortunately most oral cancers are only discovered in the later stages.
Oral cancer is one of the most common of all cancers. Anyone can get oral cancer but the risks are greater if you are male, over 40 years old, and use tobacco and alcohol. Sun exposure is a risk for lip cancer—just as it is for skin cancer. The risk of cancer is now increasing in younger age groups and is associated with the human papillomavirus (HPV-16) which is also responsible for most cases of cervical cancer.
The most common symptom of oral cancer is a mouth sore that does not heal or an irritation that does not go away. Other symptoms may include:
- A red or white patch (or speckled red and white) anywhere on the lining of the mouth, lips or throat
- A lump, thickening, crusty or eroded area
- Difficulty in chewing or swallowing, speaking or moving the tongue
- A soreness or feeling something may be caught in the throat
- Numbness or loss of feeling, or pain and tenderness
- Changes in fit of dentures
- Dramatic or unexplained loss of weight
Figure: Cancer and pre-cancerous patches may occur anywhere on the lining of the mouth and typically appear as red or white patches.
To reduce your chances of developing oral cancer:
- Visit your dentist at least once a year for an oral cancer screening examination. Your regular dental check-up is an excellent opportunity for your dentist or dental hygienist to check your face, neck, lips, and entire mouth for possible signs of cancer. Even if you have complete dentures and no natural teeth, it is important to have your mouth checked every year for oral cancer. Early diagnosis increases the chances of successful treatment outcomes.
- Do not smoke or use any tobacco products (smokeless tobacco or spit tobacco has been shown to increase the risk of oral cancer)
- Drink alcohol only in moderation
- Eat a well-balanced diet rich in nutrients
- Limit exposure to the sun
- The American Academy of Oral and Maxillofacial Surgeons recommends that everyone perform an oral cancer self-examination each month as early detection and treatment provides a better chance for cure. To conduct a self-exam:
- Remove any dentures or appliances
- Look and feel inside the lips and front of gums
- Tilt head back to inspect and feel the roof of your mouth (palate)
- Pull each cheek out to see inside its surface and the back of the gums
- Pull the tongue out and look at all surfaces
- Feel for any lumps in either side of the neck and under the lower jaw.
Call your dentist’s office immediately if you notice any changes in the appearance of your mouth or any of the signs and symptoms mentioned above.
Figure: Perform a self-exam looking under the tongue and as far back into the throat and into the palate as possible. Don't forget the cheeks.