Breast Cancer & Dental Health
Breast cancer is the second leading cause of death among women in the United States. About 1 in 8 U.S. women will develop breast cancer over the course of her lifetime. In 2011, an estimated 230,480 new cases of invasive breast cancer were expected to be diagnosed in women in the U.S., along with 57,650 new cases of non-invasive breast cancer, with almost 40,000 deaths in 2011 alone. Many women’s lives could be saved if this cancer was diagnosed earlier, and early diagnosis could be achieved if there were more and easier opportunities to do so.
Risk Factors of Breast Cancer
These include smoking, alcohol use, genetics, and others. Studies have also shown a link between breast cancer and dental health. You may be 11 times more likely to develop breast cancer if you have poor oral health or periodontal disease. Journal of Breast Cancer Research and Treatment conducted a survey of over 3,000 people and found that individuals with chronic periodontal disease had a higher occurrence of breast cancer.
The researchers found that the protein levels in saliva have shown potential to assist in the diagnosis, treatment, and follow-up care of breast cancer. Dentists would be the perfect choice to take periodic saliva samples during regularly scheduled visits. This would aid the patient and physician greatly before, during, and after diagnosis and treatment.
Salivary testing has some real advantages over blood testing. The studies say that saliva collection is safe, non-invasive, and can be collected without causing a patient any pain or discomfort.
This method of early diagnosis is not yet approved by the Food and Drug Administration (FDA). If it does receive approval, dentists and physicians could use it to diagnose breast cancer as a team. It is good to remember that salivary testing would not be a final diagnosis. Patients would still need to undergo routine breast cancer exams (including mammography and blood screening).
Dental Health Factors
More than one-third of people being treated for breast cancer can develop complications that affect the mouth. These complications can affect your quality of life. Preexisting or untreated oral disease can even complicate cancer treatment. This is one reason to make sure you visit your dentist at least one month before beginning cancer treatment. Most chemotherapy agents suppress white blood cells, which protect against infection. Chemotherapy can also effect saliva production, leading to dry mouth, and serious dental implications. The oral tissues can become very inflamed, cavities can become rampant, and gums may bleed easily. All dental work should be completed and the teeth should be cleaned prior to cancer therapy. Oral infection can be hazardous when your immune system is suppressed. Most patients are treated with chemotherapy, radiation, or both. If you are also taking bisphosphonates, such as Fosamax, Boniva, etc., you may be putting yourself at further risk for bone problems. Recent studies suggest long-term use of such bisphosphonates may develop into destruction of the jaw bone. The risk significantly increases with chemotherapy.
How to Minimize Side Effects
More than 1/3 of people being treated for breast cancer can develop complications that affect their oral health. Chemotherapy agents can cause a person’s mouth to become inflamed (also referred to as mucositis). This can be very painful for the patient affecting swallowing, taste, appetite, speech, and even sleep.
To maintain good oral hygiene during treatments, a woman can do the following:
- Brush with a soft toothbrush or sponge brush to clean your teeth and gums.
- Floss gently and regularly.
- Only use alcohol-free mouthwash, preferably one free of saccharin, but one containing
- When white blood cells counts are reported by your physician to be low, avoid dental
- Avoid dental treatment for about a week after chemotherapy.
- Inflammation starts with red gums that may bleed. Even slight bleeding should not be
- Use toothpaste and chewing gum with xylitol.
- Regular dental visits to identify problems before they develop.
- If you wear dentures, make sure you keep them clean and that they fit well. Make sure to
take them out at night.
- Research shows that rinsing with chlorhexidine gluconate twice per day for 2 weeks,
then twice per week through the remainder of cancer therapy will keep oral bacteria
levels down. A prescription strength neutral sodium fluoride toothpaste and rinse should
be used daily. Fluoride trays should be fabricated for you by your dentist and worn for a
few minutes each night throughout therapy to help prevent cavities.
- If you develop mucositis, your dentist can prescribe an oral rinse to calm and soothe the
Most patients are treated with chemotherapy or radiation. However, some patients may be treated with bisphosphonates, such as Fosamax, Boniva, and others. Recent studies suggest long-term use of such bisphosphonates may develop into destruction of the jaw bone. The risk is low but increases with chemotherapy.
Breast Cancer Conclusion
Breast cancer treatment is a difficult time for all that must go through it. Being aware of the side effects, will help you to avoid many of the potential problems. By practicing good oral hygiene, you can decrease bacteria levels in the mouth and consequently, some of the side effects of breast cancer treatment. Visiting your dentist at least one month before beginning cancer treatment can help you fight potential threats to your oral health ahead of time. Breast cancer treatment should be a coordinated team effort which should include your physician, oncologist, and your dentist.