The longer I live with metastatic breast cancer, the more I understand the importance of complete, supportive and open conversations with the entire health care team before treatment starts or treatment changes are made.
Simple commonsense, right?
But when you are newly diagnosed, it takes focus to do what you might quickly suggest to a friend or family member. When you’re facing a stage 4 diagnosis or progression, the focus—at least for me—was very narrow: Stay alive.
I understand how things like dental care sort of fade into the background for many of us, including me. Between regular oncology appointments, treatments, heart scans, blood work, CTs and MRIs and all the other less frequent but still necessary appointments, it’s hard to add something else.
I actually don’t remember anyone on my care team saying something about making sure I had a dental appointment before starting treatment. Like everything else from that time, I’m willing to admit that maybe I just didn’t hear it because, yep, my focus was pretty narrow. I do remember that once we knew I wasn’t the suspected stage 2, the speed of my treatment planning moved even more quickly. Was there time for me to go to the dentist? Probably not.
These days, a full seven years later and still receiving targeted treatment, I flash back to my own thoughts from that time. I think I knew I should see a dentist, but I chose not to.
In the subsequent years, I’ve tried to take good care of my teeth, but the fact is that cancer and cancer treatments can cause oral damage regardless of what you do. I’ve been lucky to not need bone-strengthening treatments, which are linked to the development of osteonecrosis of the jaw. However, there is a long list of other oral health problems associated with cancer that require diligence.
For me, I have had a variety of saliva and gum issues over the years of my treatment. I now require oral surgery for a tooth, though I am not yet sure what the surgeon will recommend about ongoing care.
All of this is to say that oral care is so important for everyone but especially for people living with cancer, where both the disease itself and its treatments, including head/neck radiation, can cause permanent damage. In the United States, it’s a real problem that many people don’t have and can’t afford care.
Some states have free or reduced care available through dentallifeline.org and you can search for dental school care programs at coda.ada.org, which may have more affordable options.
Cancer.net, the American Society of Clinical Oncology’s patient-focused website, has information about risk factors as well as care guidelines (search “Dental and Oral Health” on their site). I am reassured that I have followed many of their recommendations, but my oral health has nevertheless been affected by cancer. For those who’ve delayed seeing a dentist, the suggestions are relatively easy to implement:
Gently brush your teeth and floss regularly. I can attest to the fact that a very soft toothbrush helps to ease gum pain and reduce bleeding. You should be sure to talk to your dentist about how to best brush/floss in your specific circumstances. Make sure you tell your health care team if there’s a lot of bleeding.
Watch your diet. Soft and mild foods are likely to be the gentlest on your oral health. Hot, cold, acidic or sugary foods can all result in oral issues, including pain. cancer.net advises speaking with a nutritionist or dietician about what is least likely to irritate your mouth,
Promote bone health Talk to a nutritionist and be sure to consult your oncologist before adding any supplements, some of which can affect treatment efficacy. Getting enough vitamin D and calcium can help promote strong jaws and teeth.
I would add that making time to see a dentist is worth the effort and expense because oral care, just like any health issue, generally doesn’t improve on its own and grows more costly the longer you wait.
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