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What does radiation do to the teeth?

Do other cancers and/or their treatments affect teeth?

There are three ways in which cancers and/or their treatments can affect teeth. The first is when the cancer affects the maxillary or mandibular (jaw) bones. This can happen with any cancer that has a tendency to spread to bones, although it is more common in cancers of the head and neck area or cancers, such as multiple myeloma, that could directly affect the bones or grow in the tissue of the sinuses or the upper respiratory tract. In these cases, the actual bone structure may not be able to support the teeth. Often, Drs. recommend that the teeth be removed prior to treating the bones. If treatment requires bone removal, the teeth would be removed as well. Reconstruction can replace the bone and dentures can be made to accommodate chewing.

Radiation therapy is a type of therapy, which targets cancers locally. For example, if the head and neck region is treated with radiation therapy for plasmacytoma, only that part of the body would be affected. As a result, the side effects of treatment are also localized. If a person is to be radiated in the head and neck region, a dental consult is usually obtained prior to treatment. The purpose is to take care of any pre-existing problem (damaged teeth should be removed) so that it does not become a bigger problem during therapy. Since healthy tissue is damaged as well as the cancerous tissue, a person would be more prone to infected teeth (abscess) if the teeth are not properly assessed before treatment.

Chemotherapy is a systemic type of cancer treatment. That is, chemotherapy enters the body and treats the whole body. The purpose is to treat any cancer cells that may not be addressed with localized therapy. One of the side effects of chemotherapy is inflammation of the mouth lining, thus breaking the first barrier between organisms and the blood stream, as well as a reduction in blood counts, making a person more susceptible to infection. If a person has unhealthy teeth, an infection could arise and, during chemotherapy, spread due to the low blood counts. An infection in the bloodstream can make a person very ill and, may be, life threatening.

Good oral hygiene can eliminate the need for extensive dental work. During therapy, especially with extensive high dose chemotherapy, good oral hygiene will decrease the incidence of in general, and dental side effects.


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