Cancer and the Mouth

The dentists at Pi Dental Center provide important services for dental patients before, during, and after cancer treatment. The oral cancer examinations that we perform regularly can make the difference in a patient’s survival from life-threatening oral cancers. Oral and pharyngeal cancers are treatable in their early stages. In this article we discuss cancer and the mouth.

Oral Cancer Today

Approximately 9,000 Americans are killed by oral cancers each year, exceeding the death rates for cervical cancer, malignant melanoma, and Hodgkin’s disease.

The five-year survival rate for oral cancers is the lowest of all major cancers, but it doesn’t have to be. If the 40,000 new cases of oral cancer reported each year were detected early, the prognosis for survival would be remarkably better–even better than for most other forms of the disease.

The main risk factors for oral cancers in the United States are the chronic use of tobacco and alcohol products and exposure to the sun. Eliminating risk factors and early detection can help reduce the morbidity and mortality of oral cancers.

Early Signs of Cancer

Failure to identify early signs of malignancy results in the progression of oral cancers, often with chronic pain, loss of function and irreparable facial and oral disfigurement.

Most of these cancers (oral cavity and pharyngeal) are readily identified in the tongue, lips, floor of the mouth, soft palate, tonsils, salivary glands and back of the throat.

The tongue and floor of the mouth are the primary sites for oral cancer. More than 90 percent of all oral and pharyngeal cancers occur in people over 45 years of age with a 2-to-1 male to female ratio.

Chemotherapy or Radiation Treatment

The National Cancer Institute reports that 40% of people who undergo chemotherapy develop oral complications. The oral mucosa is particularly susceptible to ulceration immediately following chemotherapy. However, these complications can be minimized by beginning cancer treatment with healthy teeth and gums. NCI recommends that a dentist familiar with the oral effects of cancer therapy examine the patient two to four weeks before beginning treatment.

Head and neck cancer patients require special oral health care measures. Our dentists work closely with physicians and medical specialists to diagnose, evaluate and treat these patients effectively. A thorough dental evaluation is necessary to diagnose present or potential problems prior to cancer radiotherapy or chemotherapy.

Good oral hygiene also can help to minimize the effects of cancer treatment on the oral tissues. Our dental hygienists review proper oral hygiene and emphasize the importance of vigilance during the cancer treatment period.

Patients Receiving Radiation Therapy

Before radiation therapy:

* Comprehensive oral examination
* Radiographic examination
* Necessary extractions
* Dental cleaning
* Necessary restorations
* Pretreatment casts and registrations
* Oral hygiene instruction
* Antimicrobial mouth rinses

During radiation therapy:

* Intensive preventative maintenance
* Fluoride treatments
* Topical anesthetics
* Antifungal medications
* Dietary counseling

After radiation therapy:

* Regular dental evaluations
* Oral surgical treatment
* Antibiotics
* Prescribe hyperbaric oxygen treatment
* Daily application of fluoride gel
* Salivary substitutes
* Review of oral hygiene procedures

Patients receiving chemotherapy

Before chemotherapy treatment:

  • All sources of bacteria should be eliminated before onset of chemotherapy.
  • During chemotherapy treatment:
  • Only the minimal necessary dental intervention should be provided to control acute dental problems occurring during active phases of chemotherapy.

After chemotherapy treatment:

  • Definitive dental care is provided for patients between chemotherapy cycles. Consultation and coordination with the oncologist are mandatory. Journal American Dental Association, Vol. 127, April 1996 and the ADA Oral Health Care Guidelines: Head and neck cancer patients receiving radiation therapy: Patients receiving cancer chemotherapy and The War on Oral Cavity and Pharyngeal Cancer.

View Video about How Cancer Affects the Mouth

Routine Examinations

At Pi Dental Center, routine, comprehensive oral-cancer screening examinations are conducted at every visit. Our professional team works closely with oral cancer patients who have undergone chemotherapy, radiation and surgical procedures that make oral care difficult. We work closely with patients to insure satisfactory home care.

A patient and cancer survivor discusses her treatment.

Pi Dental Center, Fort Washington, PA