DENTAL AND ORAL PROBLEMS

Dental and oral problems

A healthy mouth is important for our overall well-being and health. Important parts of the mouth are the teeth, tongue, gums, salivary glands and the jaw. Each tooth has one or more roots by which it is embedded in the gums and the jaw bone. Young children have 20 baby teeth (also called temporary teeth) in total, which fall out and are replaced by 32 adult teeth when they are 6 to 12 years old. This usually happens in two phases: the first phase between approximately 6 and 8 years, and the second phase between approximately 10 and 12 years of age.

Damage to the mouth and/or teeth can cause problems with eating, speaking and may affect overall health and the way you feel about yourself. Problems with the teeth are called dental problems. Problems with other parts of the mouth, such as the gums or tongue, are called oral problems.

Almost everyone experiences one or more dental or oral problems in their lifetime. Common dental and oral problems are a toothache caused by a cavity (a hole within the tooth), inflamed gums, a dry mouth, altered or decreased taste or sensitive teeth. Sometimes the teeth develop in an unusual way.

There are a number of things everyone can do to lower your risk of dental and oral problems, such as adopting or maintaining good hygiene of the mouth, avoiding frequent intake of high sugar foods and visiting a dental professional regularly.

Am I at higher risk of dental and oral problems?

Anyone, including people who have never had cancer treatment, may develop dental or oral problems. However, there are some cancer treatments that may increase the risk of having dental and oral problems later in life. The problems that can occur depend on the type of cancer treatment received.

The following treatments can increase the risk of dental and/or oral problems:

  • Radiotherapy to areas that include the jaw, mouth and/or salivary glands can cause problems such as a dry mouth, cavities, inflamed gums and early loss of the anchorage of teeth in the jaw, loss of taste, jaw stiffness (not being able to open your mouth fully) and problems with the development of the jaw and teeth.
  • Chemotherapy can cause problems such as a dry mouth, cavities, inflamed gums and problems with the development of the jaw and teeth.
  • Stem cell transplantation with stem cells from a donor (allogeneic) can cause dental and/or oral problems as this involves high doses of chemotherapy and sometimes also radiotherapy.

You can find out if you have received any of these treatments by looking at your treatment summary. If you do not have a treatment summary or if you have any questions, do contact your treating hospital.

If you experience dental and oral problems, it does not always mean that it was caused by your cancer treatment. Dental and oral problems may have other causes, such as poor hygiene of the mouth.

What are the symptoms and signs of dental and oral problems?

There are symptoms and signs that can tell you if you might have dental and/or oral problems. You might not have these symptoms and signs at the moment, but it is important to be aware of them in case they may develop in the future.

These symptoms and signs may suggest that you have dental and/or oral problems:

  • One or more parts of the mouth, jaw or neck feel painful or swollen
  • The gums bleed regularly when flossing or toothbrushing
  • A dry mouth
  • A change in (or loss of) taste
  • A (small) wound or ulcer in the mouth which takes a long time (>2 weeks) to heal
  • Dental cavities
  • Not losing baby teeth between 6 and 12 years of age
  • Crowded, discoloured or misshapen teeth

Small dental and oral problems are usually temporary and the problems will usually go away on their own. However, if you experience any of these symptoms or signs, please contact a dentist or follow-up care specialist. Most dental and oral problems can be treated or prevented from getting worse over time.

What happens if I have dental and oral problems?

If you have dental and/or oral problems, your dentist may treat the problem right away or may refer you to a specialist. Depending on the symptoms and/or signs you experience, you may be referred to a:

  • Dental hygienist (healthcare professional specialised in dental care)
  • Orthodontist (dentist specialised in dental and jaw abnormalities)
  • Prosthodontist (dentist specialised in restoring oral function by replacing missing or lost teeth)
  • Oral and maxillofacial surgeon (surgeons specialised in the area of the mouth)
  • Dietician (specialist who advise on eating habits and lifestyle)

The specialist may do further testing and discuss different treatment options with you.

What else can I do?

Knowing that you may be at increased risk of dental and oral problems can be difficult. Talking to friends and family can be helpful as well as specialist counselling and/or contact with support groups, such as patient organisations. For more information on taking care of your mental health, please read: Mental health problems.

To lower the risk of dental and oral problems, it is very important to live a healthy lifestyle. Taking care of your mental health may be beneficial; even small changes to your lifestyle can have a positive impact on both your physical and mental health. For more information on taking up a healthier lifestyle, please read: Health promotion.

It is also important to keep your mouth healthy, especially if you received cancer treatment. It is advised to brush your teeth twice a day for more than 2 minutes with a toothpaste that contains fluoride and to use interdental cleaning devices such as toothpicks or interdental brushes once a day. In some cases, particularly after radiotherapy involving the head and neck, specific preventative measures (such as using high fluoride containing prescription toothpaste) may be necessary. It is recommended to see a dentist at least once every 6-12 months even if you aren’t experiencing dental/oral issues.

It is important that you are aware of the possibility of developing dental and oral problems and that you know the symptoms and signs. If you have any further questions or the information in this brochure concerns you, please contact your dentist, general practitioner or follow-up care specialist.

Where can I find more information?

You may find more information about dental and oral problems online. However, it is important to be aware that this information is not always up to date or accurate.

Some sources of further information are:

On this website, you can also find more information related to this topic:

Please note

This PLAIN summary is based on the PanCareFollowUp guideline about “Dental and oral problems” [1], which is based on the consensus of different national guidelines.

While the PanCare PLAIN information group strives to provide accurate and complete information that is up-to-date as of the date of publication, you can check with your general practitioner or follow-up care specialist if this summary reflects the most up-to-date information available and whether it is relevant for you.

Please do not rely solely on this information. It is best to also seek the advice of a qualified medical practitioner if you have questions regarding a specific medical condition, disease, diagnosis or symptom.

No warranty or representation, expressed or implied, is made concerning the accuracy, reliability, completeness, relevance, or timeliness of this information. PanCare has produced the English version and PanCare is not responsible for the translated versions of this summary.

[1] van Kalsbeek, R. et al. (2021) European PANCAREFOLLOWUP recommendations for surveillance of late effects of childhood, adolescent, and Young Adult Cancer, European journal of cancer. Available at: https://www.ejcancer.com/article/S0959-8049(21)00368-3/fulltext.