Chemotherapy is the use of medications (chemicals) to treat cancer. Chemotherapy targets the rapidly dividing cells of cancer but can also affect other rapidly dividing cells, including the cells in the mouth. The mouth and teeth are also susceptible to damage because the mouth is full of bacteria, some good and some bad, and chemotherapy can upset the balance of these bacteria. The following side effects on the teeth are common for patients undergoing chemotherapy.
Tooth Decay
Tooth decay is caused by acids created by a sticky film of bacteria called plaque attacking the tooth enamel. The acid breaks down the enamel creating tiny holes (cavities) in the tooth. Patients on chemotherapy treatments are especially susceptible to decay for several reasons.
Chemotherapy affects the salivary glands causing them to reduce saliva production. This creates a condition known as xerostomia, or dry mouth. Saliva is vital to oral hygiene as it helps to prevent tooth decay. Saliva neutralizes the acid on the teeth and gums preventing it from attacking the tooth enamel causing cavities.
Chemotherapy also disrupts the balance between the beneficial and harmful bacteria in the mouth. This can allow the harmful bacteria to take over and attach to the teeth promoting tooth decay.
Delayed Growth
Chemotherapy in children can affect the growth and development of their teeth. The treatments can affect both the size and shape of developing teeth as well as delay the eruption of new teeth. Most children receiving chemotherapy for childhood cancers will have to undergo orthodontic treatments to help fix their teeth.
Pain
Chemotherapy can induce pain in the teeth and/or jaw. The pain can be caused by the patient grinding their teeth at night due to the stress of treatments. It can also be caused by the chemotherapy damaging the nerves around the teeth. This nerve damage can also lead to tooth sensitivities, to hot or cold, even after treatments have ceased.
Infection
The cells in the lining of the mouth are often damaged by chemotherapy. This damage can lead to sores and infections that can also affect the health of the teeth.
Chemotherapy destroys white blood cells weakening the immune system. This means the body is less able to fight off infections from bacteria, fungus and viruses. With a weakened immune system even the good bacteria in the mouth can cause infection.
Patients on chemotherapy are often given antibiotics to avoid infections of the mouth. If left untreated however, the infection can spread in and around the gums resulting in tooth loss.
