Daily oral and dental care is essential for all of us, and especially when the mouth area is affected by therapy. Chemotherapy for tumors in any part of the body can affect the mouth, (whereas radiation therapy affects the mouth only when applied directly).
Brushing and Flossing
Natural teeth should be brushed daily (and preferably after each meal, large or small) with a soft-bristle toothbrush. A small amount of toothpaste is useful when brushing; excessive amounts do not make up for inadequate brushing and flossing. Flossing is an effective way to clean between the teeth, but your doctor may decide that it would be too irritating for your gums. Ask his or her advice also about massaging the gums and tongue, another element in mouth care.
Bad breath, gum irritation, pyorrhea, and tooth decay may result from inadequate oral hygiene. Since the effects of tumor therapy can limit the extent of your mouth care, it is very important to take care of this area before the therapy is begun.
Dentures, like natural teeth, should be cleaned at least once a day. Brush inside and out with a denture brush; no toothpaste is necessary. Do this over a sink or bowl containing a few inches of water-if the dentures are dropped, they're less likely to be damaged. After brushing, soak the dentures in water, or in a commercial denture cleaner if you wish-but remember, soaking does not take the place of thorough brushing. With the dentures removed, vigorously rinse your mouth with water or, again, a commercial mouth rinse. These simple procedures, performed daily, indeed after every meal or snack, will keep your mouth in the best possible health.
Some types of therapy, however, cause mouth sores and irritated gums (mucositis), and measures beyond simple hygiene may be needed.
If you have mouth sores, stay away from irritating or spicey foods. Eat a bland, soft diet. Remove your dentures until the sores heal. Rinse four times daily with a 3% hydrogen peroxide solution diluted to half strength with water. If you find this solution irritating to your mouth, continue diluting the solution until it no longer has this effect. You may also try a commercial mouthwash (such as Cepacol®). If your gums bleed very easily or are tender, use swabs, Toothettes®, or a damp cloth to clean your teeth and gums. Other non-irritating appliances are also available commercially.
If dry mouth is a problem, your doctor may suggest an artificial "saliva" (such as Zero-lube®, or Saliva-aid®) but these products are not always successful. Another solution may be a saliva stimulant (such as Pilocarpine®). A simple and often effective remedy for dry-mouth is frequent rinses with water and sucking on ice chips. Sugarless tart candies or chewing gum may also help. The problem should not be ignored; keeping your mouth moist is essential both to oral health and to comfort.
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Editor's Note: This article was authored by Becky Moore, RN