Managing Dental Health During Cancer Treatment

According to statistics from the Ministry of Health and Welfare, cancer has been the leading cause of death in our country for 40 years.

The incidence of cancer has increased by an average of 4.2% annually, and the number of cancer patients in 2023 was reported to be 1,950,925, an 18.1% increase compared to 2019.

Additionally, if South Korean citizens live up to their life expectancy (83.6 years), the probability of developing cancer is 38.1%. It is estimated that 2 out of 5 men and 1 out of 3 women will develop cancer.

Cancer has become a common disease, highlighting the importance of being cautious and vigilant throughout life. Furthermore, since cancer treatment periods are long and it takes a considerable time to achieve a complete cure, many patients wonder how to manage dental treatment during chemotherapy.

Cancer treatment can be broadly divided into surgery, radiation therapy, and chemotherapy. 

Starting radiation therapy and chemotherapy can cause various short-term and long-term complications in the oral cavity. Inflammation of the oral mucosa, dry mouth, taste disorders, and difficulties in swallowing may occur..

Additionally, reduced immunity and easy bleeding can lead to small wounds or mouth infections developing into more serious infections.

Let's look at managing dental treatment before, during, and after chemotherapy.

First, before undergoing chemotherapy, it is essential to have a dental check-up. This removes any potential dental issues that could cause problems later, preventing situations where teeth need to be extracted or dental surgery is required. At the same time, the body is weakened, and recovery is slow due to chemotherapy.

Since chemotherapy suppresses the immune system and increases the risk of infection, even minor issues must be treated and resolved in advance.

For example, teeth that are untreatable or have only roots remaining should be extracted in advance, and it is also advisable to extract teeth with severe periodontal disease that are loose.

Partially impacted wisdom teeth, which have the potential to cause inflammation, should be considered for extraction as well. Sharp dental prosthetics should be smoothed to prevent injuries inside the mouth.

In cases where chemotherapy needs to start quickly after diagnosis, such as with acute leukemia, there may not be enough time for dental treatment. However, for some solid tumors (e.g., lung cancer, breast cancer, prostate cancer), there may be sufficient time to receive dental treatment.

Extractions should ideally be performed at least two weeks before starting chemotherapy to allow soft tissue to heal before the treatment begins.

Secondly, it is ideal to receive dental treatment during chemotherapy before chemotherapy starts. However, if treatment is unavoidable, it can only be performed when the patient's hematologic condition is favorable.

Consult the patient's internist about their hematologic status and consider the use of prophylactic antibiotics. If the patient's condition is not good, postpone dental treatment until after the completion of chemotherapy.

Thirdly, after completing chemotherapy, all dental treatments can be performed. However, patients who have undergone chemotherapy often experience dry mouth and are more susceptible to dental caries. Additionally, if they have received radiation therapy to the jaw area, there is a risk of osteonecrosis, which requires caution during tooth extractions.

During chemotherapy, changes in immune function and hematologic status increase the risk of infection and bleeding tendencies. Therefore, invasive dental surgeries and other procedures that could cause infections must be cautiously approached.

Conducting thorough dental examinations and addressing problematic teeth before starting chemotherapy is crucial.

Even after chemotherapy, the risk of oral complications remains high, so paying extra attention to oral hygiene is essential. Proper dental care and maintenance are vital to minimize the risk of complications and maintain overall oral health.