Both radiation and chemotherapy can cause changes in the mouth and teeth. Awareness of the potential problems coupled with good preventive care can help keep your child more comfortable during treatment.
Some anticancer drugs and radiation can cause changes in children's ability to salivate. Plaque may build up rapidly on your childs teeth, increasing the chance for both cavities and gum infections. Take your child to the dentist for cleaning and check-up every three to four months, as long as his counts are good (ANC more than 1,000 and platelets more than 100,000). If your child has a central venous catheter, he should be given antibiotics before and after each visit to the dentist. Ask your dentist to refer to the current issue of the Pediatric Dentistry Reference Manual to formulate a dental plan.
Get recommendations from your childs oncologist and dentist for advice on tooth care when counts are very low. Often parents are advised to use a sponge or damp gauze to gently wipe off their child's teeth after meals instead of brushing.
My daughter had problems with thick yellow saliva during the entire time she was treated. It coated her teeth and formed a lot of plaque. I brought her to an excellent pediatric dentist every three months to have the plaque removed. She took antibiotics half an hour before treatment and then again six hours afterward. He also put sealants on all of her molars and, even though there were many weeks when her teeth could not be brushed, she never got a cavity.
Some parents report delays in the arrival of their childs permanent teeth. Children who receive chemotherapy or cranial radiation therapy may have poorly developed or absent permanent teeth, as well as blunted tooth roots, increasing the possibility of premature tooth loss.
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