Uncle Wang confirmed that lung cancer before intermittently have the phenomenon of toothache, has not been taken seriously, after the recent two chemotherapy, Uncle Wang's toothache problem has been committed again, and the pain is unbearable, it turned out that chemotherapy caused pulpitis! The doctor suggested that in order to avoid risks, treatment should be carried out after the patient's physical condition is restored, and this "special period" Uncle Wang can only endure pain and regret not going to see the teeth before chemotherapy!
Tumor treatment is a "long battle", although it is a small matter about the teeth, it can also become a "time bomb" in the treatment process, not only increasing the pain, but also may affect the treatment process!
The relationship between tumor treatment and oral health should also start from the side effects of various types of tumor treatment.
Chemoradiation
Radiotherapy can reduce the number of periodontal cells by reducing the blood supply to periodontal tissue, break the fibers, and disorganize the orientation, ultimately leading to a widening of the periodontal space [1].
Chemotherapy can cause cytostatic or cytotoxic effects. Due to the rapid renewal of oral mucosal cells, the complexity of the microbiota in the mouth, the vulnerability of oral tissues to trauma, and other factors, oral tissues are very sensitive to the toxicity of chemotherapy [2].
For patients who lack good oral hygiene, there is a significant increased risk of rapid destruction of periodontal tissue. In the case of occlusal trauma, changes in root morphology and crown root ratio, the degree of damage to periodontal tissue is further aggravated, which affects the long-term stability of the tooth.
Therefore, radiotherapy and chemotherapy greatly increase the incidence of periodontitis and pulpitis in patients. Once the patient has the problem of pulpitis and periodontitis due to the side effects of radiotherapy and chemotherapy, it is bound to have a greater impact on the patient's anti-cancer treatment!
This is because tumor patients during radiotherapy and chemotherapy are affected by bone marrow suppression, wounds are not easy to heal, and the treatment of periodontitis, pulpitis need to carry out related surgery, in order to avoid risks, doctors often recommend that patients do tumor-related treatment after treating teeth, so that patients can only choose conservative treatment, endure the pain of toothache!
Targeted therapy
A class of drugs - anti-angiogenesis agents - is often used in tumor targeted therapy, which, like radiotherapy and chemotherapy, will also bring some adverse reactions to the body at the same time.
For example, sorafenib and sunitinib may have neutropenia during use, resulting in severe bone marrow suppression, or wound healing disorders have occurred in clinical trials related to bevacizumab. The appearance of these adverse reactions also affects the treatment of oral problems such as periodontitis and pulpitis.
Immunotherapy
Immunotherapy itself has little to do with the oral health of tumor patients, but when tumor patients develop oral inflammation (such as periodontitis, pulpitis, root canalitis, etc.) during immunotherapy, they may need to be "anti-inflammatory treatment" with antibiotics.
However, relevant studies have shown that antibiotics may reduce the effectiveness of cancer immunotherapy methods, which is not conducive to cancer treatment. Therefore, it is not easy to deal with oral problems during immunotherapy.
How to avoid oral problems during treatment?
Good brushing habits and correct brushing methods are the key to maintaining oral hygiene and periodontal health, and the scientific brushing frequency is to brush your teeth 2 times a day for at least 3 minutes each time.
The use of floss can remove plaque on the adjacent and root surfaces of the teeth, which can effectively prevent adjacent caries and root caries.
During treatment, eat less sweets or beverages that are likely to cause caries; avoid spicy and irritating foods and foods that are too cold or too hot.
Alternate use of teeth on both sides for chewing, if you often use unilateral teeth for chewing, it will lead to the other side of the tooth lack of physiological stimulation, easy to appear tissue atrophy, and the side that often chews will be overloaded, easy to form pulpitis.
bibliography
1. Lotus bud. Short-term observation of periodontal tissue changes after radiotherapy[J]. China Medical Innovation, 2016, 13(9): 124-126
2. ZHANG Peipei. Effect of periodontal treatment on periodontal condition in patients undergoing postoperative chemotherapy for oral and maxillofacial malignancies[D]. Zhengzhou University,2016.]