How does chemotherapy affect your teeth and gums?

Maybe your mouth feels drier than usual, or food doesn't taste quite right anymore. If you're going through chemotherapy, changes like these in your mouth are common, and they don't necessarily mean something has gone wrong. They happen because treatment affects fast-growing healthy cells in your mouth along with cancer cells. Most of these effects ease up after chemotherapy ends, but some need attention while treatment is underway. 

What you will learn in this article: 

• Chemotherapy can affect healthy cells in your mouth as well as cancer cells. 

• Many oral side effects improve after treatment, but symptoms can vary. 

• Seeing a dental provider before treatment can help find problems that may cause trouble later. 

• New mouth pain, sores or bleeding should be reported to your dental provider and oncology team. 

If you are starting chemotherapy or already notice changes in your mouth, schedule an appointment with an Aspen Dental provider. Your care team can check your mouth and help you manage symptoms during treatment. 

Why does chemotherapy affect your mouth? 

Chemotherapy is made to damage cells that grow and divide quickly. Cancer cells do this, but some healthy cells in your mouth and bone marrow do too. The American Dental Association explains that this is why treatment can also affect the lining of your mouth and your blood cell counts. 

These changes can cause mouth sores, dry mouth, infections, taste changes and pain. A drop in white blood cells can make infection more likely, while a low platelet count can make bleeding easier.¹ 

What is chemotherapy-induced oral mucositis? 

Oral mucositis is a painful mouth problem that can happen during chemotherapy. It may cause sores that make eating, speaking or swallowing uncomfortable.² 

How is oral mucositis treated? 

Treatment depends on how severe the sores are. Your doctor or dental provider may recommend a medicine that protects the lining of your mouth or one that numbs sore areas.² Ask your care team before using a medicated mouth rinse or other product. 

Why does chemotherapy cause dry mouth? 

Dry mouth, also called xerostomia, happens when you do not have enough saliva, or spit, to keep your mouth moist. Chemotherapy may affect the glands that make saliva and change its amount or texture. 

Less saliva can raise your risk of cavities and infections. It may also make chewing and swallowing harder. For many people, dry mouth from chemotherapy improves after treatment ends and damaged tissues heal.¹ 

What helps with dry mouth during chemo? 

Try sipping water throughout the day, and check with your care team about whether sugar-free gum, sugar-free candy or ice chips are safe options for you. Some people also find artificial saliva products helpful.² Your dental provider can recommend products that fit your symptoms and cancer treatment. 

Can chemotherapy cause gum bleeding or sensitivity? 

Yes. Chemotherapy can leave your gums sore or inflamed. It can also lower your platelet count, making your mouth more likely to bleed.¹ 

Tell your dental provider and oncology team if your gums bleed more than usual. They can review your symptoms and blood counts and help you decide whether your oral care routine needs to change. 

Does chemotherapy raise the risk of tooth damage? 

Chemotherapy does not always damage teeth directly. However, dry mouth can reduce the protection saliva gives your teeth, raising the risk of weakened enamel and cavities. 

Some chemotherapy medicines, including vinca alkaloids, can cause a deep ache or burning feeling in a tooth even when no dental problem can be found. If your child is the one receiving treatment, it's worth knowing that high-dose chemotherapy may also affect tooth, jaw or facial development in children, especially those younger than age 9.¹ Tell your dental provider and oncology team about new tooth pain or changes in your child’s mouth. 

Why does chemotherapy change how food tastes? 

Chemotherapy can change the way food tastes. Food may not taste the way it usually does, which can make eating harder during treatment. Tell your oncology team if taste changes make it difficult to eat or drink. They may recommend foods that are easier to tolerate or connect you with a dietitian. 

Should you see a dental provider before starting chemotherapy? 

The National Institute of Dental and Craniofacial Research recommends seeing a dental provider about one month before cancer treatment begins to make sure your mouth is healthy.² This gives your dental provider time to find and treat problems that could cause trouble during treatment. 

Your dental provider and oncology team should share information about your health and treatment plan. Learn what may happen during a pre-treatment dental evaluation so you know what to expect. 

What should you do if you notice mouth changes during chemo? 

Tell both your oncology team and your dental provider about new mouth symptoms. These may include sores, bleeding gums, tooth pain, dry mouth, white patches or trouble swallowing. Your care teams can work together and decide what care is safe during treatment. 

Ask your oncology team before starting any vitamins or supplements. Also tell your dental provider about every medicine you take. Other medicines, including some heart medications, may affect your mouth too. 

Mouth changes during chemotherapy can be difficult to manage alone. Contact your local dental provider to review your symptoms and discuss care that fits your treatment schedule. 

How does chemotherapy affect your teeth and gums? FAQs 

Still have questions about chemotherapy's effects on your mouth? These answers cover a few common concerns. 

Should you still brush and floss during chemotherapy? 

Continue caring for your mouth unless your care team tells you otherwise. Use a soft toothbrush and fluoride toothpaste, and brush gently. If your gums are sore or bleeding or your blood counts are low, ask your dental provider or oncology team whether you should change how you floss. 

Can dry mouth from chemotherapy lead to other problems? 

Yes, but there's a lot you can do to manage it. If sipping water, sugar-free gum or artificial saliva aren't enough, ask your dental provider about a prescription-strength fluoride treatment to add extra protection against cavities while your saliva is reduced. Let your care team know if dryness is severe or doesn't improve, since it can be managed differently depending on how long your treatment lasts. 

Is mouth pain during chemotherapy always caused by mucositis? 

No. Mucositis causes painful mouth sores, but certain chemotherapy medicines can cause a deep ache or burning feeling in a tooth. Tell your dental provider and oncology team so they can look for the cause. 

Can children have different oral side effects from chemotherapy? 

Yes. If your child is having high-dose chemotherapy, ask their oncology team whether a pediatric dental provider should be part of their care team from the start. Regular dental visits during and after treatment can help catch changes in tooth or jaw development early, when there's more that can be done about them. 

Who should you tell about a new mouth problem during chemotherapy? 

Tell both your dental provider and your oncology team as soon as you notice something new, even if it seems minor. New sores, bleeding, pain or fever can sometimes signal an infection that needs quick attention during cancer treatment. Your care teams would rather hear about a small change early than have it become a bigger problem later, and they can decide together whether you need to be seen right away or can wait for your next visit. 

Sources 

¹ American Dental Association, Library and Archives: “Cancer Therapies and Dental Considerations.” https://www.ada.org/resources/ada-library/oral-health-topics/cancer-therapies-and-dental-considerations 

² National Institute of Dental and Craniofacial Research: “Cancer Treatments & Oral Health.” https://www.nidcr.nih.gov/health-info/cancer-treatments