Chemotherapy and effects on the oral cavity

Chemotherapy and effects on the oral cavity

The pathologies encountered today are increasingly varied, more frequent, their detection poses problems in certain situations and treatments cure on the one hand but damage other organs and systems on the other.

Carcinomas with a starting point or extending into the oral region are common and, depending on the segments affected, may have a milder or harsher prognosis.

The main disadvantage of tumors developed in the oral cavity is that they can be difficult to detect, especially for those located posteriorly.

If they don’t hurt, if they don’t hurt during chewing, if they don’t produce significant bleeding and if they don’t present ulcerated areas that alarm the patient, they can be easily overlooked.

Most of the time, tumors in the oral cavity are treated by excision with free safety margins, followed or not by chemotherapy, depending on the surgeon’s indications.

Effects of chemotherapy

The effects of chemotherapy in the oral cavity are varied and can be simple forms or, conversely, complicated forms that prevent the patient from leading a normal life. Among the most common effects of chemotherapy are the following:

  • Xerostomia and hyposalivation – chemotherapy affect the flow of saliva so that its effects will be fully felt orally. Dry mucous membranes, low saliva secretion and dry mouth are some of the symptom’s patients may report.

Also, if the patient is wearing dentures, they will lose their fit and even cause damage to the edentulous ridges.

Normally, the saliva film stabilizes the dentures on the fully edentulous fields.

The decrease in the amount of saliva is quite quickly felt by patients.

A reduced amount of saliva can also result in poor and painful swallowing. Insufficiently salivated food bowl does not slide smoothly to the lower structures of the digestive tract. Xerostomia may be the trigger for tooth decay.

  • Infections – chemotherapy considerably decreases immunity, i.e. the body’s strength and ability to defend itself against bacteria. Normally, the flora of the oral cavity contains bacteria which, if kept at a certain low level, do not cause damage. However, bacteremia, i.e. increased bacterial gradient, together with decreased immunity, leads to oral infections. Against a background of pre-existing lesions, bacterial contamination produces ulcerations which can become purulent and difficult to treat.

  • Mucositis – is inflammation of the oral mucosa, a complication that occurs in the majority of chemo-treated patients. It is manifested by the appearance of oedema, ulceration and erythema and can be fairly well controlled by a rigorous hygiene protocol.

  • Osteonecrosis – is characterized by continuous, progressive pain of the oral cavity and occurs in patients with bone metastases who are usually treated with bisphosphonates.

The bone will have a low consistency, is soft, brittle, spontaneous fractures may occur, sometimes triggered by sneezing or yawning. Also, if dental extractions are performed, the bone will remain denuded and healing will be incomplete.

Each of these conditions can be improved, if not treated. This is why the advice of your dentist is helpful in these situations.

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