Cancer of any kind may have implications that are not immediately obvious to patients, including the effect of treatment on the mouth. As such, dental teams must work closely with medical providers to ensure steps are taken to prevent negative impacts on the mouth, and to provide effective care when it is needed. In order to do this, clinicians must always seek information about a patient’s medical history and any treatment they are receiving, making sure they are well informed about the consequences of any treatment on the teeth and gums. This will enable them to provide the most impactful advice, and improve their patient’s situation.
Risks
Patients with cancer have an increased risk of oral complications occurring due to treatment for a number of reasons. Both chemotherapy and radiation therapy slow or stop the growth of cells, with the aim to prevent fast-growing cells like cancer cells being produced. However, normal cells in the lining of the mouth are also fast-growing. When a patient is undergoing these treatment types, the ability of the tissue in the mouth to repair itself by making new cells is hindered. Further to this, radiation therapy has the potential to directly damage soft tissue in the mouth, salivary glands, and bone. Additionally, the healthy balance of bacteria in the mouth can be disturbed by both radiation therapy and chemotherapy, leading to sores, infections, and tooth decay over time.
Whilst patients undergoing cancer treatment are at a high risk for these complications, it is important that clinicians help patients throughout the process – before, during, and after treatment – to minimise the potential impacts. For example, prior to treatment, it may be helpful to treat any existing oral problems. During treatment, clinicians should help to manage any problems that occur, and long-term management of side effects is needed to help keep teeth and gums healthy once therapy is complete.
Painful side effects
It is important to be aware of the specific side effects that may impact patients undergoing cancer treatment, so that you and your patient can prepare for, prevent, and manage any issues as they occur. For example, patients may experience inflammation, infections, changes in taste, dry mouth, and pain, along with tooth decay and gingival disease. Further to this, treatment may affect patients’ ability to eat and drink as normal, potentially resulting in malnutrition and dehydration.
One of the most common side effects of cancer treatment is oral mucositis – inflammation of the oral mucosa – which can be caused by both chemotherapy and radiation therapy, and presents as ulcers.
Offering helpful advice
Oral mucositis can result in pain which ranges in severity, so it is important to offer patients pain management advice whilst they undergo their course of treatment. Some recommendations include sucking on ice or lollies and sipping cool drinks for mild cases, with patients potentially requiring prescription pain medication in severe cases.
It can be helpful to recommend the use of topical pain relief, such as gels containing benzocaine, to provide a temporary break from pain. Orajel Mouth Gel contains 10 per cent benzocaine for effective relief from areas of the mouth which are painful and tender. Patients can apply the gel directly to painful areas, giving them complete control over the product for targeted pain relief. Only a thin layer is required to temporarily block pain signals along the nerves, numbing the area in under two minutes. Patients should be sure to clean the teeth and mouth using a soft toothbrush after meals and before applying a topical treatment such as this.
By recommending the use of a topical benzocaine gel, patients benefit from pain relief exactly where it is needed, helping to improve their quality of life and reduce the emotional distress often associated with toothache.
Patients may not be aware of the oral complications associated with cancer treatment. As such, clinicians must be vigilant and proactive, helping them to prepare for and prevent any potential issues, whilst managing any that do arise. Often, a big part of management during treatment is pain relief and knowing how and when to provide them with targeted topical anaesthetic is essential.
References available on request.
For more information visit www.orajelhcp.co.uk/