Oral examination is necessary prior to chemotherapy!
Dry mouth, taste changes, dry lips, and pain are often problems of chemotherapy and increase when the patient has periodontitis.
Patients with good oral hygiene have a reduced likelihood of complications and toxic effects from chemotherapy. In contrast, increased oral complications were associated with an increased risk of periodontal disease.
A study, on the frequency of oral complications in patients undergoing chemotherapy reported that close to 90% of patients had complications in the oral cavity.
The incidence of complications and toxicity increased with the increased risk of developing periodontal disease. The study was conducted at La Paz University Hospital, in Madrid, Spain, and included 369 oncology patients. According to the researchers, in oncology patients who are having chemotherapy, the incidence of side effects and complications - whether they are symptoms reported by the patients themselves or complications seen by physicians - is more than 85%.
The most common complications in the mouth were: xerostomia - dry mouth (73.4%), dysgeusia - persistent, unpleasant taste sensation (61.8%), lip dryness, other changes in the lips (55.3%), and oral pain (32.8%). Patients included in the study had received chemotherapy for a solid tumor or hematologic cancer. Prior to chemotherapy, all patients were given oral hygiene instructions by nurses specializing in oncology patients.
The largest group of patients reported that they did not smoke (88.9%) and did not drink alcohol. 77.2% of patients reported that they had a dental examination in the past 2 years and 83.8% reported brushing their teeth at least twice a day. However, only 16.3% of people used dental floss or interdental brushes on a daily basis.
The rate of oral side effects appears to depend: a) on the type of chemotherapy b) if radiotherapy is used together locally on the oral area c) on the type of tumor d) on the age, e) on the sex, f) whether chemotherapy has been used prior and g) on the daily oral care followed by the patient.
Complications of chemotherapy in the oral cavity can cause severe discomfort and pain, with difficulties in nutrition, delays in treatment and / or reduction in therapeutic dosage. Oral problems have direct and indirect adverse effects on quality of life, affecting patients' daily routines and his/her social relationships.
In conclusion, the authors point out that patients who are going to receive chemotherapy should undergo an oral health assessment, resolve their oral health problems, and be trained in maintaining good oral hygiene. This guideline can reduce the risk of complications and avoid possible secondary infections.
Garcia-Chias B, et al (2019). Prevalence of oral side effects of chemotherapy and its relationship with periodontal risk: a cross sectional study. Supportive Care in Cancer 27:3479–3490. https://doi.org/10.1007/s00520-019-4650-6