Which item is best to use when providing oral care to a client with cancer who is at risk for oral tissue injury?

You can keep your teeth for your lifetime. Here are some things you can do to maintain a healthy mouth and strong teeth.

• Drink fluoridated water and brush with fluoride toothpaste.
• Practice good oral hygiene. Brush teeth thoroughly twice a day and floss daily between the teeth to remove dental plaque.
• Visit your dentist at least once a year, even if you have no natural teeth or have dentures.
• Do not use any tobacco products. If you smoke, quit.
• Limit alcoholic drinks.
• If you have diabetes, work to maintain control of the disease. This will decrease risk for other complications, including gum disease. Treating gum disease may help lower your blood sugar level.
• If your medication causes dry mouth, ask your doctor for a different medication that may not cause this condition. If dry mouth cannot be avoided, drink plenty of water, chew sugarless gum, and avoid tobacco products and alcohol.
• See your doctor or a dentist if you have sudden changes in taste and smell.
• When acting as a caregiver, help older individuals brush and floss their teeth if they are not able to perform these activities independently.

Additional Resources

Image: Dental Health Services Victoria

Looking after your teeth and gums is important for the health of your mouth. A healthy mouth allows you to smile, eat and speak which helps your general health, mental wellbeing and ability socialise with others. Poor oral health has been linked heart disease, diabetes, respiratory illness, cancer and stroke.

Enjoying a nutritious low-sugar diet, daily toothbrushing and regular dental visits are key ways to keep your mouth feeling good and working well.

Common diseases: tooth decay, gum disease, oral cancer

The most common dental diseases include tooth decay, gum disease, and oral cancer. Let’s take a closer look at how these happen and how they can be prevented.

Tooth decay

When you consume food and drinks that are sugary or starchy (high in carbohydrates), the bacteria that naturally live in your mouth, break them down forming acids. These acids attack and dissolve the outer surface (enamel) of your teeth. Over time this can result in a hole. The risk of tooth decay is increased for people with dry mouth syndrome.

The first sign of tooth decay is a chalky white spot on the tooth. At this stage, the decay process can be reversed. If you think you might have early stage tooth decay, make an appointment to see your oral health professional.

Gum Disease

Gum disease is usually caused by a build-up of plaque (bacteria) on your teeth. There are two main stages of gum disease: gingivitis and periodontitis.

Gingivitis is early gum disease and occurs when dental plaque builds up on your teeth, particularly around the gumline. Signs of gingivitis include bleeding, redness, and/or swelling of the gums.

Periodontitis is advanced gum disease that can occur if gingivitis is left untreated. The part of the gum that joins to the tooth becomes weakened and allows bacteria to become trapped between the gum and the tooth. This can damage the soft tissue that connects your teeth and jaw bones, which can cause teeth to loosen.

Oral cancer

Oral cancer refers to cancer that develops in the lips, tongue, gums, floor and roof of the mouth. Oral cancer is the 8th most common cancer in men in Victoria, and the 14th most common cancer in women. Consuming alcohol and tobacco are the two main risk factors for oral cancer.

Oral cancer symptoms can include:

• A visible mass or lump (may or may not be painful)
• Mouth ulcer that won’t heal
• White or red patches in the mouth/tongue/gums
• Loss of sensation anywhere in the mouth
• Difficulty swallowing, moving your tongue, or moving your jaw
• Loose teeth or sore gums
• Altered taste
• Swollen lymph glands

Whilst dental diseases are common, there are several simple ways you can reduce your risk.

Clean well for a healthy mouth

Regular toothbrushing helps to prevent tooth decay and gum disease by reducing the amount of bacteria and plaque around your teeth and gums.

Tips for effective cleaning include:

• Clean your teeth twice a day; in the morning and before bed.
• Use a toothbrush with a small head and soft bristles and a pea-sized amount of fluoride toothpaste.
• Gently brush teeth and along the gum line in small circles, making sure to brush each tooth on the front, back, and chewing surfaces.
• After brushing, spit out toothpaste – do not swallow it, and do not rinse with water. This allows the fluoride more time to strengthen your teeth.

Electric toothbrushes can also be a good option. Guide the brush slowly across, pausing for a few seconds at each tooth. Do not press too hard or scrub, let the brush do the work. Find out about toothbrushing for children.

Flossing

It is important to clean between teeth where a toothbrush can’t reach. Products such as floss and interdental brushes can remove plaque from between your teeth. Talk to your oral health professional about whether you should use one of these products.

Eat well for a healthy mouth

The foods you eat impact your oral health. Sugary and starchy foods feed the bacteria that can cause tooth decay and gum disease.

Tips for eating well include:

• Limit how often you have sweet foods and eat them at mealtimes rather than between meals.
• Choose healthy snacks such as fresh fruit, vegetable sticks, natural yoghurt, plain popcorn, soups, or cheese.
• Choose fresh fruit over dried fruit, as dried fruit can stick on your teeth and feed the bacteria that cause tooth decay.
• Have a piece of cheese after eating sweet or acidic foods as dairy foods assist in repairing damage by decay-causing bacteria.

For more information on eating well, visit the Australian Dietary Guidelines .

Chewing sugar-free gum can also be helpful in the fight against decay. It can help to produce saliva, which is able to wash sugar out of the mouth into the stomach, neutralise acid, fight bacteria and repair the early stages of tooth decay.

Drink well for a healthy mouth

Like food, what you drink also impacts your oral health. Sugary drinks feed the bacteria that can cause tooth decay and gum disease. Choosing tap water (which contains fluoride for most Victorians) helps to repair the damage done by bacteria and reduces your risk of tooth decay.

Tips for drinking well:

• Drink plenty of water (fluoridated tap water wherever possible). Plain milk is also a tooth-friendly option.
• Limit sugary and acidic drinks such as soft drinks (including sugar-free/diet and regular), sports drinks, cordials and fruit juices.
• Cut down on sugar added to tea and coffee.
• Limit alcohol intake to reduce your risk of oral cancer.

Have regular dental visits for a healthy mouth

The early signs of dental disease can be difficult to see. An oral health professional is trained to spot and treat any problems early, which can prevent bigger problems developing. They can also provide you with care to prevent disease, such as fluoride treatments and dental sealants to prevent tooth decay.

Ask your oral health professional how often you should have a dental check-up. If you have not had a dental visit for a while, it might be a good idea to book one. Having no pain does not always mean that your teeth and mouth are healthy.

Always see your oral health professional if you have:

• mouth pain
• bleeding gums
• swelling of the face
• a damaged or knocked out tooth (or teeth)
• mouth sores that don’t heal after a couple of weeks.

Read more about seeing an oral health professional.

Reduce your risk of oral cancer

Tobacco and alcohol consumption are the main risk factors for oral cancer. Using alcohol and tobacco together increases this risk even more. You can reduce your risk of developing oral cancer by:

• Seeking support to Quit smoking at Quitline on Tel. 137 848.
• Drinking less alcohol.
• Protecting your face from the sun. Wear a broad brimmed hat, and use a SPF30+ broad spectrum, water-resistant sunscreen and SPF lip balm to reduce the risk of lip cancers.
• Seeing your dental professional regularly and especially if you have a lump or mouth ulcer that has not gone away after two weeks.

Mouthguards

Wearing a mouthguard when training or playing contact sport, or any leisure activity where there is risk of injury to the teeth and face, can significantly reduce your risk of injury to your teeth and mouth. Talk to your oral health professional about the best option for you.

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