02/10/2025
TEETH AND THE SIDE EFFECTS OF CHEMOTHERAPY AND RADIOTHERAPY
The oral cavity is often particularly affected by chemotherapy and radiation therapy, even if it is not directed at the head or neck. Therefore, dental care plays an especially important role in supporting cancer therapy.
SIDE EFFECTS OF CHEMOTHERAPY AND RADIOTHERAPY
• Sore spots that heal poorly
• Burning sensation
• Dry mouth, canker sores
• Numbness
• Change or loss of taste
• Cracked lips
• White patches (oral fungus)
• Inflamed gums (gingivitis) with possible periodontitis
• Bleeding gums
• Gum recession
• Ulcers on the oral mucosa and tooth decay
• Severe mouth pain, toothache with or without dental work.
• Loose teeth and tooth loss
• Difficulty swallowing
• Jawbone death (in rare cases)
• Strange taste in the mouth during chemotherapy and radiation therapy
The taste in the mouth is sometimes described in very different ways:
• Bad
• Sour
• Sweet
• Bitter
• Metallic
• Salty
Can you lose teeth with chemotherapy?
Chemotherapy doesn't usually directly attack teeth, but it does promote the development of diseases that can lead to tooth loss.
It promotes periodontitis, which can cause gum recession and inflammation of the jawbone. In the advanced stages of periodontitis, teeth are only loosely seated in the bone and may also fall out.
Chemotherapy can also disrupt the supply of nutrients to the teeth by attacking the blood, lymph, and nerve tissue. This can quickly lead to chronic inflammation of the tooth root.
Radiation Caries
If radiation therapy is applied to the head and neck area, the risk of tooth decay increases. More complex treatments such as root canals are not recommended during cancer treatment; simple fillings to treat cavities can be performed without problems. So make sure your teeth are checked regularly.
Mandibular Necrosis from Radiation Therapy or Bisphosphonates
Mandibular necrosis is the most serious side effect of radiation therapy to the jawbone and occurs when the jawbone has been damaged. It can also occur as a side effect of bisphosphonates, drugs used in patients with bone metastases to stabilize bone and mineral balance.
Important:
If you are taking bisphosphonates, be sure to inform your dentist, as this can significantly influence the choice of treatment. In the case of jaw necrosis caused by bisphosphonates, for example, wounds heal very poorly after tooth extraction.
Before Starting Treatment
Immediately after a cancer diagnosis, it is important to schedule a dental visit, as cavities and periodontitis are aggravated by a weakened immune system and damage to the oral mucosa and teeth caused by cancer treatment.
It is not advisable to extract teeth or perform root canal treatment (endodontics) during radiation therapy or chemotherapy because it increases the risk of infection.
Dental rehabilitation before starting cancer treatment may include the following measures to be performed in the dental office:
• Treatment of cavities, periodontitis, and root inflammation
• Removal of dental plaque and tartar through a professional dental cleaning (gum pocket cleaning if necessary)
• Grinding of sharp edges on teeth and dentures
• Extraction of teeth that are not worth preserving
• Extraction of implants that are not worth preserving (which could cause complications during radiation therapy)
• Removal of root debris
• Treatment of mucosal defects
• Treatment of pressure points (with prosthetics) and fitting
• Fluoridation of teeth to protect them from caries
• Fabrication of a radiation protection splint
• Fabrication of a fluoridation splint
For any questions, please make an appointment and visit us.
