Living With

Chemo and Your Teeth

Phyllis Johnson Health Guide January 30, 2009
  •             I did try to make a dental appointment, and if I’d known how important it was, I would have tried harder. 

                I moved to the Kansas City area from North Carolina in December of 1997.  As 1998 began, I was working two part-time jobs, looking for a full-time job, and doing all the usual settling in activities involved in a new place.  Although I was due to have my teeth cleaned, finding a dentist was low on my To Do list.  In March and April, I added doctors’ appointments to my schedule as I tried to find out what was causing my breast symptoms.

                By the third week in April, I knew that I had inflammatory breast cancer (IBC) and that I’d be in for a long treatment of chemo, surgery, and radiation.  Somewhere in all the material I was reading and trying to absorb, I saw that I needed to have dental work done before starting chemo.

                That’s when I actually picked up the phone and called started calling dentists only to find out that no appointments were available for months for new patients.  My chemo was scheduled to begin in two weeks, so I just let it go.  Big mistake! 

                I understood from what I had read that having dental work done while on chemo wasn’t advised because of the risk of infection.  I didn’t understand that a simple cleaning falls under the category of dental work that can’t be done while on chemo.  I also didn’t understand that the chemo itself would be rough on my teeth.

                Affecting any rapidly dividing cells in the body, including those lining the mouth, chemo often leads to a dry mouth.  As the section on oral health and chemo at cancer.gov explains, “Saliva is needed for taste, swallowing, and speech. It helps prevent infection and tooth decay by neutralizing acid and cleaning the teeth and gums. . . . When dry mouth develops, the patient's quality of life suffers. The mouth is less able to clean itself. Acid in the mouth is not neutralized, and minerals are lost from the teeth. Tooth decay and gum disease are more likely to develop.”

                I don’t know how fair it is to blame chemo for the crowns and cavities I’ve had since chemo.  I’m getting older; they might have happened anyway.  But when I did finally get in to see the dentist, he confirmed that the extreme sensitivity I had developed was a chemo side effect.  For years I couldn’t tolerate hot or cold foods.  Coffee and soup had to be tepid.  It usually took a couple of tries before the servers in restaurants really believed me when I said “No ice” in my cold drinks.

                My dentist said that oncologists should routinely prescribe extra fluoride to their chemo patients and make sure that they have that cleaning before chemo.  Maybe these days oncologists are more aware of dental side effects from chemo, but my oncologist didn’t mention the importance of taking care of my teeth.

                If I had known how crucial it was, I would have been more insistent about getting that dental appointment.  I could have asked the oncologist to make a referral.  I could have camped out at the dentist until they decided it was easier to work me in than have me sitting in the waiting room.

  •             So if chemo is in your treatment future, make an appointment with your dentist and discuss what you need to do to keep your teeth healthy during chemo.