Oral And Dental Health In Patients Receiving Chemotherapy And Radiotherapy

As the number of cancer cases increases, so does the number of people receiving cancer treatment. Chemotherapy, bone marrow transplantation, radiotherapy to the head and neck area can lead to a deterioration of oral health. This situation negatively affects patients’ diet and speech and reduces their quality of life. For patients receiving radiotherapy and chemotherapy, necessary precautions should be taken before, during and after treatment. Complaints that may occur in patients receiving cancer treatment:

• Inflammations and ulcers in the mouth (mucositis)
• Infections (fungal, bacterial and viral infections due to suppression of the bone marrow, dry mouth, damage to the mucous membrane due to radiation or chemotherapy)
• Dry mouth (occurs due to decreased saliva flow. It causes difficulty in chewing, speaking and swallowing and increases the risk of infection)
• Trismus (jaw blockage due to spasms of the jaw muscles)
• Taste changes, inability to taste food
• Feeding disorders
• Disorders of dental, head and facial development (in paediatric patients receiving radiotherapy or high-dose chemotherapy)
• Dental caries due to dry mouth
• Osteonecrosis (It occurs as a result of decreased vascularity and nutrition in the jaw bones in patients receiving radiotherapy to the head and neck. Inadequate patient oral care, dry mouth, tooth extraction, prosthetic trauma after completion of radiotherapy, periodontal disease all increase the risk of osteonecrosis)
• Continuous, deep stabbing and burning pain that is not of dental or gingival origin but mimics toothache. This condition occurs as a result of nerve damage caused by some drugs used in chemotherapy
• As a result of bone marrow suppression, bleeding in the mouth may occur due to a decrease in clotting factors and platelets.
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Treatment methods to resolve these complaints:

• Oral mucositis = Topical anaesthetics and painkillers are recommended. If the infection has developed, the situation is clarified with the patient’s doctor for antibiotic treatment.
• Dry mouth = Increasing water consumption, chewing sugarless gum and eating food in small pieces is recommended. It may be necessary to use saliva stimulants or artificial saliva (Xialine Gs oral spray, Pilocarbine HCl tablet).
• Trismus = Jaw opening and closing exercises, muscle relaxants are recommended.
• Loss of substance in the enamel tissue = Gargling with sodium bicarbonate water is recommended.
• Herpes infections = It is recommended to take 400-800 mg of aciclovir orally for five days. In severe cases, 5-20 mg/kg of aciclovir is administered intravenously two to three times a day.
• Varicella-zoster infections = Treatment with high-dose aciclovir or valaciclovir.

We wish you healthy days