But the first and
only words that
came out of my
mouth at that
perhaps to a fault.
‘When is your
your hygienist?’ I
When is your appointment with your hygienist?
Dental care during cancer treatment is pivotal
As any health-care professional will tell you, there are
moments during interaction with a patient when time
seems to stand still. Having served as a pharmacist for
over 30 years now, I have had my fair share of these
However, this moment was definitely different. It
did not occur with me clad in my white coat behind
the security of a prescription counter of a retail pharmacy or safely immersed in the anonymity of a crowd
of attending physicians and medical students during
rounds at a hospital.
It happened at the conclusion of a continuing education seminar I had presented recently to dentists and
hygienists on cancer, its pharmacologic treatment,
associated oral complications, and potential dental
She had been standing in the background for most
of the presentation, leaving and returning on cue to
facilitate the service of meals, the removal of empty
plates, and the filling and refilling of beverage glasses.
When the audience had left and the room was mostly
empty, she stood before me and said the words that
made time stand still.
“I was just diagnosed with breast cancer,” she said
softly. “What should I do now?”
Immediately my brain was flooded with a torrent of
information, textbooks I had read, images of neoplasms
I had seen, articles I had written, and lessons I had
taught to students over the years.
At the same time, I was also inundated with emotion,
fears of the future for my family members I knew who
were at high risk, hopes I had kept and prayers I had
said for those I knew who were currently fighting for
their lives, and memories of all of my loved ones who
were lost to this tragic disease.
In retrospect, I know I could have, and should have,
said something that was much more consoling, more
supportive, and more hopeful to this wonderful woman
who approached me for my advice after listening to
me speak all day.
But the first and only words that came out of my
mouth at that pivotal moment were simple, perhaps
to a fault.
“When is your appointment with your hygienist?” I
Most, if not all, people know someone who has or
had cancer. Unfortunately, many cancer patients and
their families are unaware that cancer treatments may
affect the oral tissues and that visiting their dental office
is an important part of the overall treatment.
EASING ORAL COMPLICATIONS
Cancer treatments, especially chemotherapy, affect
dental treatment planning, prioritization, and timing.
While chemotherapy is designed to be toxic to cancer
nately, it may also
be toxic to nor-
mal, rapidly di-
viding cells, such
as those of the
tract and hair fol-
licles. As a result,
effects of chemo-
and hair loss.
mouth is also a
prime target for
the adverse effects of chemotherapy. Normal cells in
the lining of the mouth also grow quickly, so chemo-
therapy may also halt their growth as well. This slows
down the ability of oral tissue to repair itself and may
lead to an array of oral complications. Necessary dental
treatment and proper oral hygiene prior to, during, and
after cancer treatments can reduce the incidence and
severity of these oral complications.
Why the concern? Oral complications from chemotherapy can seriously compromise patient health and
RPh, CCP, is a
pharmacist who also
serves the professions of
dentistry as a clinical
speaker, and published
author in the areas of
pharmacology and local
anesthesia. Tom is a
member of the faculty of
10 dental professional
degree programs and is
well-known for his
regular contributions to
professional journals. Tom
has presented hundreds
of continuing education
courses, nationally and
internationally, and has
earned his reputation as
the go-to specialist for
practical and useful for all
members of the dental