Hear from Joss Harding, Dental Hygienist about the effects cancer treatment may have on your oral hygiene and advice that can help.

This may not be quite what you might expect to hear from a dental professional - this is true, however for you this is important. To keep your weight up during treatment please eat and drink as wide a variety of foods and drinks as possible – so a little of what you fancy does you good.

From the moment of diagnosis oral health is usually the bottom of the list of priorities. Through treatment you may have problems with your mouth, and I have highlighted some of these below. Some of these side affects you may find can be short term and some long term. Your mouth is the window to your body so keeping your mouth clean helps to keep your whole body healthy.

Tooth decay Lack of saliva allows plaque bacteria to accumulate and become sticky in difficult to reach areas. Frequency of snacks and high sugar or acidic drinks can lead to tooth decay. You may be recommended a high fluoride prescription toothpaste to use during treatment to help reduce the risk of tooth decay. You only need to use a pea sized amount, at least two times per day and do not rinse afterwards. If you wish to use a mouth rinse, please use at a different time of day. Please be careful of sucking mints or sweets, consider xylitol versions to help reduce the risk of tooth decay.

Gum Disease Bleeding gums, also known as gingivitis, affects many people and is an indicator of plaque bacteria remaining on the gum line longer than the body is happy with. To reduce the inflammation, concentrate brushing along the gum line cleaning the gums as well as your teeth. Be prepared for bleeding initially and then this will reduce with improved cleaning technique. If you can clean between your teeth with floss or interdental brushes, please try and do this once per day, check this with your oncology team as this is not recommended with certain cancer treatments. Remember to change your electric toothbrush head or manual toothbrush every 3 months.

Dry mouth is a common problem, and this can vary. Keep hydrated with regular cups of water ideally 6-8 a day. There are many suggestions available to help, saliva substitutes, lubricants, and stimulants: sprays, gels, mouthwashes, mints, pastilles, and gum available to try on prescription or over the counter.

Sore mouth known as mucositis, can be a difficult side effect but often subsides at the competition of treatment. Try to keep your teeth as clean as possible during this time, maybe consider a soft toothbrush to help.

Thrush A common fungal infection caused by candida albicans especially when your system is low. Please keep orthodontic retainers or dentures clean, remember to rinse after using inhalers, keep corners of your mouth clean and dry and this can help to keep this fungal infection at bay.

Toothbrushes Which to choose? Either can be used and both have benefits. Depending on your finances an oscillating and rotating electric toothbrush gives a great clean. The toothbrush design and the power it has will make a difference to your teeth. It can be easy to brush too hard with a manual toothbrush, so this is something to be aware of. A way to check how well you are cleaning is with disclosing tablets, do you remember these from school days and staining your teeth to show the plaque present?

Toothpastes  Which is best? Check your toothpaste contains fluoride, all major brands will contain fluoride. During treatment, your appetite may change, and you may prefer to graze rather than eat large meals. Whilst grazing your teeth are more prone tooth decay, this is due to regular sugar/acid attacks, fluoride toothpaste will help to keep your teeth strong throughout this time. If you are sick during treatment please use a fluoride toothpaste but do not brush straight after vomiting, maybe consider a mouthwash to freshen. This will make your mouth feel more pleasant and then toothbrush later, ideally 30 to 40 minutes after vomiting.

On completion of treatment

As soon as you are given the OK from your oncology team to return to your dental team, please book an appointment for a dental examination. Your support team will be more than happy to give further advice and suggestions. Your team will do their utmost to advise you and make your journey the best it can be.