Treatment of children for cancer causes changes in the bio-environment of the mouth, making it more susceptible to oral infections and tooth decay. Most chemotherapy drugs cause all dividing cells to die, and since the mucous membranes are composed of rapidly dividing cells, these tissues do not replenish during intense therapy. Mucous membranes form a barrier against infections, and without them the mouth can become inflamed, and opportunistic bacterial, yeast, and fungal infections can occur. Chemotherapy also affects the ability to salivate, causing plaque to build up rapidly, thus increasing the incidence of gum infections and cavities. Treatment can cause drops in ANC so that the child is less able to fight off infections which do start. Low platelet counts mean that even brushing and flossing can cause bleeding. Last but not least, development of teeth is sometimes adversely affected by radiation and intensive chemotherapy protocols.
Oral infections and tooth decay during chemotherapy can usually be prevented by antibacterial mouth washes and careful, frequent teeth cleanings. That's easy for a kid to do, right? Ha! Getting healthy kids to brush twice a day requires diligent parents. Getting a prednisone-laced child to carefully wash and rinse his mouth after every meal, well, that can be very difficult.
The first sections below teach you good oral care practices for chemotherapy patients. Dr. Mark, a dentist who is the parent of a young boy with ALL, is the professional advisor. His procedures for home care are both dentist- and child- approved. Later sections discuss dental visits and long term effects of treatment.