Dental Care and the Lung Cancer Patient

Has your oncologist talked to you about your dental health, beyond asking if you have mouth sores? Oncologists are busy people and we patients have so many questions about our cancer treatment. We can miss asking about important areas affecting our overall well-being (and our wallets). If you are being treated with systemic cancer treatments, they likely are affecting your oral health.

Tips for good oral hygiene

Here are my tips for taking care of your mouth as you fight cancer. These tips can help both newly diagnosed lung cancer patients and those who have been under treatment for a while.

Make a dental appointment as soon as possible after you learn you have lung cancer

Get a good cleaning and fix any lurking dental problems as soon as you can. Cancer treatment may make it more difficult to deal with dental issues in the future.

Keep your dentist informed about which treatments you are on

Some treatments can limit what the dentist can do if you do have a dental problem. For example, if you are on Avastin (bevacizumab), your dental hygienist and dentist are going to need to be very gentle with your gums. You cannot have dental surgery such as extractions unless you stop taking the drug for a while. Xgeva (denosumab) is another drug that increases the risk of necrosis of the jaw.

Good dental hygiene is as important as ever

When I was on chemo, I noticed that my teeth became coated and icky feeling much more easily. The better we clean our teeth, the more likely we are to prevent tooth decay and the need for invasive dental procedures.

You may need to change the dental care products you use

Many cancer treatments can make your mouth very sensitive to harsh and spicy flavors. A minty toothpaste I had used for years burned my mouth when I first started taking Tarceva (erlotinib). You can find many products made for sensitive mouths at your pharmacy. I got good results by switching to gentle fruit-flavored dental products made for children. Your dentist can also prescribe a mild toothpaste that is higher in fluoride. A simple saline rinse can be very helpful after meals.

Consider using an electric toothbrush and water flosser

You can be too diligent in your tooth cleaning efforts! Scrubbing your mouth clean is hard on both your teeth and your gums. In my case, I was brushing too vigorously and found that it was easier to correct the problem by using an electric toothbrush. I make sure I have the softest manual toothbrush I can find on hand for those times when the electric toothbrush needs to be recharged, or I have to travel alone and leave it home. My dental hygienist recommends water flossers but cautions that they should be used on a gentle setting.

Watch out for receding gums

Unfortunately, once gum tissue has been worn away, it is gone forever. If your gums start to recede, talk to your dentist as soon as possible. A gentler touch may be enough to stave off future damage.

Keep your mouth moist

Saliva protects the mouth as well as making it easier to swallow food. My dentist says that dry mouth is a leading cause of sudden, widespread tooth decay. Rule one in cancer treatment is to stay hydrated, and this will help. There are also several products on the market for dry mouth that you can use if this seems to be an issue for you. The most enjoyable solution is a special kind of candy that does not contain sugar. My dentist strongly recommends sucking on xylitol hard candies to both stimulate saliva and suppress the bacteria that cause tooth decay.

Remember...you are worth the investment

A friend with lung cancer has talked about the quandary of deciding whether it is worth spending money on expensive dental care when you don’t know how long you will be able to benefit from the investment. Anyone who has ever had a toothache knows that not getting needed dental care can have very unpleasant results.

I remember thinking after my diagnosis that it was now a waste of money for me to acquire anything new -- including clothes, yarn for my knitting hobby, and eyeglasses. My new oncologist told me, “You have to get your new glasses. People need to get these things even if they only use them for a week.” Quality of life is important, and dental health (and having the right eyeglasses) is part of living the best life you can.

Editor’s Note: We are extremely saddened to say that on June 27, 2019, Anita Figueras passed away. Anita was a valued member of the Lung Cancer community and an incredible advocater. She will be deeply missed.