Taking Care of Dental Conditions while Undergoing Chemo: Dry Mouth

When I was diagnosed with cancer, no one told me anything at all about how important it is to visit a dentist right away. It has only been since I have had the disease for a while and have listened to other people discuss all of the oral health issues they have had that I realized what a problem it can be.

I learned a lot during a Webinar entitled “Making the Mouth-Body Connection During Cancer Care.” Jill Meyer-Lippert, a registered dental hygienist, gave us a lot of valuable information during her one-hour presentation.

After diagnosis, see your dentist as soon as possible

First of all, if you can, get to a dentist immediately after you are diagnosed with cancer. Go before you begin cancer treatments. Play the cancer card, if you must. Let the person who makes the appointments know how critical it is for you to see the dentist as soon as possible.

The reason it is important to see your dentist right away is that once you begin cancer treatments you may not be able to have dental work done. There are too many risks involved in having dental work when you are so susceptible to infections. Besides, if you have cavities or other dental issues, fixing them before you begin treatment may help reduce the risk of developing side effects to cancer therapies. An unhealthy mouth can actually interfere with your treatment.

Amazing, isn’t it? Even though the National Institute of Dental and Craniofacial Research says that more than one-third of all cancer patients develop complications that affect the mouth, the most the majority of us are told, if we are told anything at all, is how to use a baking soda mouthwash to help prevent mouth sores.²

Some solutions do more harm than good

Complications affecting the mouth may include mild to severe side effects such as mouth sores, infections, dry mouth, sensitive gums, and jaw pain. And, unfortunately, some of the standard remedies that we are given by our oncologists aren’t the wisest choices for combatting the issues.

For example, Meyer-Lippert told about one of her patients who was a breast cancer survivor. Her cancer treatments had caused her to suffer from dry mouth. The oncologist’s office advised her to suck on lemon drops. The patient was thrilled because the hard candy was helping with the problem. But, Meyer-Lippert says that sucking on sugary, acidic candy is exactly what you should not do. The sugar can promote cavities, especially if your mouth has been compromised due to decreased saliva production.³

Why is saliva important?

Dry mouth, which is technically called xerostomia or hyposalivation, is definitely an issue we want to address. Saliva is very important to our overall health. Below are a few of the ways it helps us:

1. It helps us digest and taste our food (this is particularly important since so many of us have issues with food tasting good while undergoing chemotherapy.)
2. Saliva acts as a lubricant to protect the sensitive tissues in our mouth from sores and infections.
3. It protects our teeth and neutralizes acids in our mouths.
4. Saliva is the mouth’s janitor. It loosens and sweeps away food particles to help prevent tooth decay by controlling bacteria, viruses, and fungi in our mouth.³

Managing dry mouth

So, what can you do if you, like so many of us, suffer from dry mouth? Below are some hints that were given on the Webinar and/or in the articles listed in the reference section below.^1,2,3

1. Stay hydrated!! Suck on ice cubes. Sip on water. Avoid alcohol and caffeine.
2. Take care of your dry, cracked lips by using balms or oils, such as bee balms or olive or coconut oil. Avoid petroleum products that put a coating over the lips, potentially trapping bacteria and causing worse problems.
3. It may be necessary to modify your medications. Talk to your oncologist!
4. Your doctor can prescribe saliva stimulants, if necessary. There are some over-the-counter saliva stimulants that contain xylitol (be careful if you have dogs – it is deadly to them) or erythritol that will work by tricking the nervous system into producing saliva.
5. Avoid smoking, salty foods, acidic juices, and dry foods, all of which contribute to dry mouth.
6. Make sure any mouthwash you use is alcohol-free. Alcohol dries the mouth and will make symptoms worse.
7. Gums, hard candies, or lozenges can help, but make sure to avoid those with sugar. Sugar promotes cavities, especially if your mouth is compromised because of reduced saliva.
8. Low-sugar diets and excellent oral hygiene will protect against the risk of gum disease, tooth decay, and other oral problems.

Advocate for yourself and your health

Many oncologists ignore or are unaware of how important dental health and care is to the overall well-being of their patients. Advocate for yourself and make sure you are getting the help you need to address dry mouth issues. A free booklet from the National Institute of Dental and Craniofacial Research called "Chemotherapy and Your Mouth" might help guide your discussions and decisions.