Side effect series: Cancer treatment and your oral health

Published: 23 Apr 2020

Continuing our side effect series, we are looking at the effects of cancer treatment on your oral health.  Many of the drugs used to treat cancer can lead to dental health problems during and immediately following treatment, and some people suffer more than others. What's good to know is that symptoms will clear up one treatment is finished and are not long-lasting.

We've searched the internet to provide you with some information and helpful tips from reputable sources.

Typical side effects include:

How do different kinds of treatment affect your mouth?

Chemotherapy drugs kill cancer cells, but they may also harm normal cells, including cells in your mouth. The type of problem will depend on the chemotherapy drugs and how your body reacts to them.

Bone marrow and stem cell transplantation patients are particularly prone to oral problems. The high dose of chemotherapy usually given before a marrow or stem cell transplant can cause many side effects.

Radiation therapy to the head and neck also increases the risk of tooth decay and gum disease ad many patients say the consistency of their saliva changes.

Bone-modifying medications such a bisphosphonates and other newer drugs are sometimes used to reduce the spread of cancer cells to the bone. They can also be used to treat breast cancer that has spread to the bone or to treat osteoporosis in breast cancer survivors. An uncommon but serious side effect of these medications is medication-related osteonecrosis of the jaw. This causes weakening and loss of bone in the jaw, which can cause pain, infection, loss of teeth, and exposed bone around the jaw.

Targeted therapies are designed to target specific genes, proteins, or the tissue environment that contributes to cancer growth and some can have side effects that affect the mouth, such as sores.

Immunotherapy can also cause side effects in the mouth, including mouth sores, and patients often experience changes to their saliva.

Other medications that help manage cancer symptoms and side effects may also cause dental and oral side effects. For example, painkillers can cause dry mouth. An some mouth rinses that are used to treat infections may discolor teeth.

What can you do to reduce problems?

Call your medical team when your mouth hurts

Don't suffer in silence, relieving side effects is an important part of cancer care and treatment. Work with your medical team to find the right solution for you, to help reduce the side effects and to control the pain. You may require specially prescribed pain relief, antibiotics, antiviral and antifungal drugs, as well as gels and mouth rinses.

Visit your dentist

Having good dental health before your start treatment will help to minimize the impact of the drugs on your mouth. Visit your dentist 3 weeks prior to cancer treatment, or as early as you can. If you've already started, don't worry, but make an appointment as soon as possible. It's important to have a check-up to sort out any potential problems and to give your mouth the best chance of staying healthy.

Keep your mouth clean

Gently brush your teeth and tongue at least 2 times a day. Use an extra-soft toothbrush and soak in warm water to soften the bristles before brushing. Try using a child-size, soft toothbrush if your regular brush is too bulky and uncomfortable. Your doctor or dentist may also recommend using a special toothpaste or treatments such as a gel or rinses.

Mouth rinses that contain salt and baking soda may help treat mouth sores. Rinse your mouth several times a day with a solution of 1/4 teaspoon baking soda and 1/8 teaspoon salt in one cup of warm water. Follow with a play water rinse. However, if you are taking high blood pressure medication, you may need to avoid mouth rinses with salt. If in doubt, check with your medical team first.

Floss your teeth gently every day. If your gums bleed and hurt, avoid the areas that are sensitive but keep flossing your other teeth. If you notice a lot of bleeding, tell your medical team,

Be careful what you eat and drink

Consider eating foods that are soft and mild such as cooked cereals, mashed potato, and scrambled eggs. If you are having trouble swallowing, try softening foods with gravy and sauces.

Avoid anything that's too hot or cold, spicy, acidic, or crunchy foods such as tortilla chips - they may irritate or scrape the inside of your mouth leading to sores.

Lower your sugar intake and avoid sugary things like candy or soda. the bacteria in your mouth use sugar to live, and this process makes the acid that causes tooth decay.

Avoid drinking alcohol and tobacco products - they can irritate your mouth leading to further problems.  

Check out these articles for healthy, easy to swallow recipes to try if you are suffering:

Fruit and veg smoothies for chemo patients
Chicken soup and other delicious comforting recipes
6 Super Soups
6 sensational smoothie recipes to kick chemo into touch

Keep your mouth moist

Make sure you have a low-sugar drink on hand - water is always best. As well as keeping your mouth moist it will also help flush away toxins more quickly.

Related articles you may find of interest:

5 reasons to drink water during chemotherapy
Delicious cancer-busting ice-creased and sorbets for summer

Strengthen your bone health

This is particularly important for anyone taking bone-modifying medication. Getting enough vitamin D and calcium each day helps your jaw and teeth stay strong and healthy. Dairy products are good sources of calcium and are often fortified with vitamin D.  Other good food choices may include fortified juice and breakfast cereals.

Talk to your medical team before taking any supplements.

Other articles about oral health:

Helpful remedies for your mouth and throat


If you are suffering with dental health problems whilst on treatment you can find support and advice from over 7,000 people, many of whom are undergoing cancer therapies right now, at the Chemotherapy Support Group on Facebook.

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