What’s the Connection Between Breast Cancer and Oral Health?

If you or someone you love is being treated for breast cancer, you know firsthand what a daunting experience it can be. Unfortunately, its challenges can also extend to patients’ oral health.

Dry mouth, oral sores, a heightened risk of oral infections—these and other breast cancer treatment side effects aren’t mere inconveniences. They can cause physical discomfort and emotional distress during an already difficult time.

Understanding the relationship between breast cancer and oral health is essential for improving treatment outcomes for patients’ physical and emotional health, and their quality of life.

Possible Oral Side Effects of Breast Cancer Treatment

Do the powerful chemotherapy drugs that slow or stop cancerous cells’ growth also have an impact on cells other than the ones targeted? Does radiation for breast cancer affect your teeth?

The answer to both questions is, “Yes, it’s possible.” Breast cancer treatment side effects can impact the teeth, gums, and structures in the mouth and face.

Studies have shown that cancer treatments can affect patients’ oral health in profound ways. For example, 40-90% of patients who receive chemotherapy may develop oral side effects including dry mouth, mouth sores, bleeding gums, and tooth loss.

The most common complications of both chemotherapy and radiation therapy include:

• Tooth pain and mouth pain.
  

• Tooth decay.

• Gum disease, due to decreased immunity and changes in the mouth’s microorganisms (oral flora).
• Changes in taste, which can lead to changes in diet and nutrition.
  
• Dry mouth (xerostomia)—reduced saliva production that elevates the risk of cavities and oral infections.
  

• Mouth sores (mucositis)—inflammation of the mouth’s mucous membranes, or inner lining, that can cause physical discomfort and make eating and speaking difficult.
  
• Oral infections, such as oral thrush—a fungal infection caused by a yeast called Candida, and usually presenting as white lesions on the tongue or inner cheeks—and infections that can travel through the bloodstream, threatening the whole body.

Chemotherapy, specifically, can also cause:

• Easy bleeding in the mouth.
  
• Inflammation and ulcers of the stomach’s or the intestines’ mucous membranes.
  

• Nerve damage.
  

• Increased susceptibility to oral infections because chemotherapy lowers the white blood cell count, compromising the immune system.

Radiation therapy can cause:

• Growth of fibrous tissue (fibrosis) in the mouth’s mucous membranes.
  
• Breakdown of tissue and bone in the area receiving radiation. Osteoradionecrosis is a rare but serious condition in which bone tissue in the jaw dies.

Managing the Oral Impacts of Breast Cancer Treatment

By promptly addressing their oral health concerns, breast cancer patients can focus on their primary treatment with fewer hindrances and discomforts.

Some management of oral side effects of breast cancer treatment can be straightforward. For example:

• To manage dry mouth, patients can sip water regularly, use readily available over-the-counter saliva substitutes, and avoid caffeine and tobacco, which can make dry mouth worse.
  
• To manage mouth sores, patients can use topical numbing agents or oral rinses as prescribed, and by avoiding spicy and acidic foods that might further irritate the mouth.
  
• To manage oral thrush, patients can rinse with a saltwater solution and avoid sugar-rich diets, which promote fungal growth.

In all cases, patients need to maintain a proper oral hygiene routine, including brushing and flossing, and to engage in regular dental checkups.

Why Preventive Measures and Collaborative Care Matter

Because breast cancer and its treatment are known to have significant impacts on oral health, a proactive and collaborative approach to oral health can help mitigate the risks of infections, tooth decay, gum disease, and other dental complications.

In a podcast interview with Breastcancer.org, Dr. Thomas P. Sollecito, professor of Oral Medicine at the School of Dental Medicine at the University of Pennsylvania, stressed how important it is for patients with breast cancer to see their dentist before, during, and after cancer treatment.

Dental examinations can catch preexisting problems and give the dentist a chance to treat them. “If a patient is able, in terms of time and fitting things in, [to go for an] examination before chemotherapy is started,” said Dr. Sollecito, “theoretically the risk goes way down, because you’ve potentially eliminated any infection before the chemo starts.”

Dr. Sollecito added, “Most dentists are equipped to see patients that . . . are having [oncology] treatment. . . . It’s really important that dentists work together with the patients’ oncologists to provide the appropriate and timely care that’s necessary.”

When dental health specialists and oncologists work together, patients receive holistic care, face a reduced risk of oral and overall health complications, and can experience greater psychological well-being. Maintaining a healthy smile can help patients cope with the physical and emotional stresses of their breast cancer journey.

Do you need to talk with a dentist about your or your loved one’s breast cancer and oral health?

Get expert and compassionate care from the specialists at Penn Dental Family Practice.

Schedule your appointment online now, or call us at 215-898-PDFP (7337).