A mouth sore that won’t heal. A rough, crusty spot on the lip that won’t go away. A cough or hoarseness that doesn’t clear up. In some cases, these might be symptoms of mouth or throat cancer.

Others include

• red or white patches in the mouth that won’t go away
• pain or tenderness in the lips or throat
• a lump or thickening in or around the mouth or throat
• trouble chewing, swallowing, speaking, or moving your jaw or tongue
• trouble opening your mouth
• a change in the way your denture fits or your teeth fit together.

Mouth or oral cancer develops on the lips, in the front of the mouth or tongue, under the tongue, in the hard part of the roof of your mouth, or on the insides of the cheeks.1 Throat or oropharyngeal cancer attacks the back of the mouth, including the throat, the back part of the tongue, the soft part of the roof of the mouth, and the tonsils.

Tobacco use is the major risk factor for cancers in the front of the mouth and lips, especially when it is combined with heavy alcohol use (> 4 drinks per day). Infection with the human papillomavirus (HPV) causes most of the cancers that develop in the back of the mouth or throat.

REDUCING YOUR RISK

Tobacco There are several avenues you can take to help cut the cord with tobacco. Some actions you can take include

• talking to your dentist or health care provider
• meeting with a therapist 1-on-1
• getting together with a group of people who also want to quit

In addition, there are several medications that also may help. They include pills, patches that you wear on your skin, and nicotine replacement gum.

Any one of these might be enough to help you quit using tobacco. Some studies indicate that a combination of actions and medications are more helpful for some people3 It often takes more than1 attempt before a person will succeed in quitting. Talk to your dentist or physician about approaches you might try.

HPV infection

Nearly 70% of cancers in the back of the mouth and throat are linked with HPV infection. Many people are exposed to HPV, but the virus usually goes away without making them sick. In some people, though, the virus doesn’t go away. Years later, it can cause any of several types of cancer to develop, including cancers of the mouth and throat.

Because HPV can lie quietly in your body without making you sick for a number of years, you can be exposed at an early age and not even know it. That’s why, the Centers for Disease Control and Prevention recommends children, aged 11 through 12 years get the HPV vaccine. This will help prevent infection and may prevent cancer from developing.

SUMMARY

Most cancers in the mouth and throat are caused by tobacco use and HPV infection. Tobacco users may find it easier to quit by using any of the actions listed above, medications, or both. To help prevent HPV infection, the Centers for Disease Control and Prevention recommends that 11- through 12- year-old children get the HPV vaccine.

Tooth decay is the first step to a cavity. Just like adults, even healthy babies can have bacteria in their mouths. Sugar from food or drinks can cause some types of this oral bacteria to produce acid, which can break the tooth down. This is tooth decay. Anytime a child younger than 6 years has tooth decay and needs a filling or has lost a tooth because of a cavity, he or she has early childhood caries (ECC).1 ECC can be painful, and it can make your child sickdsick enough to go to the emergency room or even have to stay at the hospital.

WHAT CAUSES EARLY CHILDHOOD CARIES?

Bacteria

The risk of developing ECC starts with the introduction of decay-causing bacteria into a baby’s mouth. This can happen anytime a baby comes in contact with someone else’s saliva, for example, through kissing on the lips or sharing a spoon.

Sugary drinks and snacks

What your child eats or drinks can set off tooth decay. Drinks like juice, formula, soft drinks, and even milk can trigger the bacteria in the mouth to produce acid. Crackers, cereal, and other starchy or sweet food can increase the risk of tooth decay, too.

WHAT CAN YOU DO?

There are some steps you can take to lower your child’s risk of tooth decay: n use fluoridated water, which helps harden the outside of teeth and protects them from decay, in your child’s bottle or sippy cup; n limit sugary snacks and drinks like crackers and juices; n do not give a bottle or sippy cup to your child when he or she is going to bed or taking a nap; n take your baby to the dentist by his or her first birthday so the dentist can check your baby’s oral health and give you tips on caring for your baby’s mouth

• start brushing as soon as that first tooth comes in (Box)
• as soon as 2 teeth come in next to each other, start cleaning between the teeth 1 time per day.

Talk to your dentist or dental hygienist about how to do this.

CONCLUSION

Baby teeth are important. Protect them from tooth decay with a healthy diet, good brushing habits, and a relationship with a dentist that starts in the first year.

Oral health care needs change with age. Often, adults deal with issues such as missing teeth, dry mouth, or mouth and throat cancer.

MISSING TEETH

There are options for replacing missing teeth. Talk to your dentist about which approach is right for you.

Bridges

Bridges may be used to replace one or more missing teeth, depending on the area of the mouth and stress put on the original teeth and bridge structure. There are 2 kinds of bridges: fixed and removable. Both use artificial teeth to fill the spaces left by missing teeth. Fixed bridges are cemented to existing teeth to hold the bridge in place. They cannot be taken out. Some bridges, however, can be removed. Removable bridges have clips that snap onto existing teeth. Often, the artificial tooth or teeth in a removable bridge can be mounted in a pink acrylic base to match the gums.

Your bridge should fit comfortably and stay in place. If it doesn’t, contact your dentist. Do not try to adjust the fit of a bridge yourself.

Dentures

Dentures are a full set of artificial teeth that can be put in and taken out. They are primarily held in place naturally with a thin layer of saliva. Sometimes a denture adhesive may be helpful. Your dentures should fit comfortably and not rub or cause sores. If you have trouble with the fit of your dentures, contact your dentist. As with bridges, do not try to adjust the fit of your dentures yourself. Implants Dental implants are artificial tooth roots that are surgically placed in the jawbone. Implants can be designed to hold one or more artificial teeth.

DRY MOUTH

Many older adults experience constant dry mouth. A number of medications can cause dry mouth, including those taken for pain, high blood pressure, depression, and asthma. Health conditions like Parkinson disease and medical treatments like radiation of the head and neck also can cause reduced saliva.

There are some things you can do to help get some relief: sucking (not chewing) ice chips, drinking sips of water often, using a humidifier, or chewing sugar-free chewing gum.

But constant dry mouth does not just mean a lack of saliva. It can merely be the feeling that your mouth is dry, even though you are producing saliva. Whether you are producing saliva or not, contact your dentist about your symptoms.

MOUTH AND THROAT CANCER

Cancers in the mouth or back of the throat are more common in adults 65 years or older. Fortunately, the chances of survival from these cancers are good if they are treated early.

Some signs to watch for include

• a sore on the lips or in the mouth that does not heal
• red or white patches in the mouth that don’t go away
• pain, tenderness, or numbness on the lips or in the mouth
• difficulty chewing, swallowing, speaking, or moving the jaw or tongue
• a change in the way your teeth fit together when you close your mouth or the way your dentures fit
• a cough, sore throat, or earache that won’t go away.

You may notice these symptoms early. Talk to your dentist if you notice any of these and make regular visits to your dentist, which will allow him or her to check for anything unusual, too.

CONCLUSION

Oral health needs change as you age, making it important that you see your dentist regularly to stay on top of these changes

When you have dry mouth most of the time, you are at risk of experiencing a number of oral health problems, such as

• tooth decay
• mouth sores
• chapped or cracked lips
• bad breath
• a sore tongue or throat
• trouble chewing, speaking, or swallowing.

Dry mouth also may affect how your dentures fit. Dentures are held in place by a thin layer of saliva. If you don’t make enough saliva, your dentures may not stay in place. Dentures that don’t fit well can slip and rub, causing mouth sores.

WHAT CAUSES DRY MOUTH?

Many things can cause dry mouth. Medications are a common reason a person may make less saliva than usual. As many as 500 medications both prescription and those you can buy over the counter (like allergy and cold medicines) can be factors. Radiation treatments for head and neck cancer often damage the salivary glands and result in chronic dry mouth. Saliva production also may be affected by diseases. Longterm diseases, such as Sjögren syndrome, diabetes, and rheumatoid arthritis, can be associated with dry mouth. It also may occur in people with conditions that develop with advancing age, such as Parkinson and Alzheimer diseases. Depression and anxiety also may be related to dry mouth.

Using tobacco or drinking alcohol or beverages with caffeine like coffee and tea and eating spicy foods also can trigger dry mouth.3 Breathing only through your mouth most of the time whether awake or sleeping also dries your mouth out.

WHAT CAN YOU DO TO HELP WITH DRY MOUTH?

You can try several things to help relieve dry mouth, including

• sipping water or sugarless drinks that don’t contain caffeine
• sucking (not chewing) on ice chips
• applying lanolin-based lip balm
• using sugar-free chewing gum or sugar-free candy to stimulate saliva production
• using a humidifier at night.

There also are several things you can avoid that might help; for example

• eating salty or spicy foods
• consuming alcoholic beverages, including alcohol containing mouth rinses
• drinking caffeine-containing beverages
• using tobacco products.

HOW CAN YOU HELP KEEP YOUR MOUTH HEALTHY?

Having low or no saliva can increase your risk of tooth decay. This makes good oral hygiene even more important. Some steps you can take to improve your oral hygiene include brushing your teeth twice a day with a soft-bristled brush and a toothpaste with fluoride in it and cleaning between your teeth once a day using floss or another interdental cleaner.

You should also visit the dentist regularly. Your dentist may be able to help determine the cause of your problem. He or she can examine you, measure your salivary flow, and talk with you about your general health, medications, or personal habits that may contribute to your dry mouth. Your dentist also may be able to help reduce your risk of tooth decay by applying a fluoride gel or varnish to your teeth or prescribing a mouth rinse or toothpaste that contains high levels of fluoride.1 He or she also may suggest that you use a rinse or gel to help keep your mouth moist.

If you wear dentures, your dentist can be alert to ensure they fit properly. If mouth sores develop, he or she may be able to adjust the dentures to help resolve the problem.

CONCLUSION

Dry mouth can lead to oral health problems like tooth decay or mouth sores. Talk to your dentist about ways to limit the effects of dry mouth.

Dental care is considered safe during pregnancy.1,2 Your dentist may work with your obstetrician when planning your treatments, but many decisions can be made without consultation. For example, many medications including some antibiotics and local anesthetics can be safely used during pregnancy. X-rays also are considered safe when a protective cover is used over your abdomen and throat.

In addition to regular visits to your dentist, you may need to see him or her for problems that might come up during pregnancy, like gum problems or dental erosion.

GUM PROBLEMS

Changes in your hormones during pregnancy may put you at increased risk of some gum problems. For example, your gums may swell or bleed when you are brushing. This form of gum disease is called gingivitis. Some extra effort in caring for your teeth at home may help prevent gingivitis

• brush twice a day for 2 minutes with a toothpaste that has fluoride
• clean between your teeth once a day with dental floss or another interdental cleaner.

Left untreated, gingivitis can lead to periodontitis. Periodontitis affects the tissues beneath the gumline that hold your teeth in place. Professional dental care is needed to treat periodontitis. Without treatment, periodontitis can get worse, and you can lose teeth.

Another gum problem that can occur during pregnancy concerns lumps along the gumline. These are generally harmless, but they can make it difficult to keep your teeth clean. They typically go away after the baby is born, but if they cause serious problems for you in taking care of your teeth, your dentist may suggest removing them.

DENTAL EROSION

Some pregnant women experience nausea. If this causes you to vomit, acid in the mouth can increase the risk of dental erosion. Constant exposure to this acid can soften and wear down enamel (the hard outside layer of your teeth). This is called dental erosion. To help reduce the loss of enamel, women should not brush their teeth immediately after vomiting. Instead, they should rinse with a diluted solution of 1 cup water and 1 teaspoon of baking soda to neutralize the acid.

WHEN TO SCHEDULE YOUR APPOINTMENT

Dental treatment is considered safe at any time during pregnancy, but you might be more comfortable during your second trimester. Nausea and vomiting are more common during the first trimester,4 which could make treatment difficult. During the third trimester, the weight of the baby may cause you to be uncomfortable or even lightheaded during treatment.5 If so, tell your dentist so he or she may see about making you more comfortable by helping you change positions.

CONCLUSION

Professional dental care is considered safe during pregnancy, can help you maintain good oral health, and manage any problems that may develop. Daily care at home is also an important part of keeping your teeth and gums healthy.

Your mouth can be affected by head and neck cancer treatment in a number of ways: oral sores, dry mouth, tooth decay, and infections such as thrush. Good home care, such as brushing twice a day with a fluoride toothpaste and cleaning between your teeth daily, will go a long way toward protecting your mouth. Here are some tips to try if you develop any of these side effects.

ORAL SORES

Oral sores are common during cancer therapy. They can range from redness to an actual open sore. Your dentist may help you manage this discomfort with a numbing cream or gel that you can apply to the affected area. This gel or cream can help numb the area or at least reduce the pain. Let your dentist know if you develop a sore.

DRY MOUTH

A dry mouth is also common during and after therapy for head and neck cancer. This is because the salivary glands, which produce saliva that keeps your mouth moist, can be damaged by the treatment. Here are some things you can try to make yourself more comfortable:

• chew sugar-free gum or suck on sugar-free candies, which may help increase the flow of saliva
• sip water at mealtime to aid in swallowing
• suck -do not chew on ice chips.

Alcohol, including alcohol-containing mouth rinses, can be drying to your mouth, so avoid it. Let your dentist know if dry mouth is becoming a problem for you. He or she might recommend the use of an artificial saliva.

TOOTH DECAY

The risk of developing tooth decay is higher than usual in people who are undergoing head and neck cancer treatment. This is because of the reduced salivary flow. Saliva not only washes food particles away from teeth and gums, but it can also contain the cavity fighter fluoride. Saliva bathes the teeth in fluoride, making the outside layer of the tooth harder. With limited saliva flow and reduced fluoride, teeth are at higher risk of developing tooth decay. Your dentist may be able to help you protect your teeth. There are mouth rinses and toothpastes that have a high fluoride content that he or she can prescribe. There are also fluoride gel treatments that can be given in the dental office. Your dentist can talk with you about which approach would be best.

MAKE YOUR DENTIST PART OF YOUR TEAM

Make your dentist a part of your treatment team as soon as possible. If you can, see your dentist before your cancer treatment begins. Your dentist can help ensure that you do not have an oral infection that could complicate your cancer therapy. In addition, your dentist is knowledgeable about your dental health; this could be helpful during your cancer treatment. He or she has a good understanding of the effects cancer treatment can have on the mouth and how to treat them.

CONCLUSION

Head and neck cancer treatment frequently affects the mouth from oral sores to dry mouth to cavities to oral infections. People who are undergoing such treatment should bring their dentist onto the treatment team as soon as possible. The dentist can help ensure that the mouth is in good health before the cancer treatment begins and can help manage oral side effects once treatment is underway and after it ends

The infection that causes COVID-19 can be spread through droplets of moisture that contain the coronavirus. Many dental procedures like dental cleanings and fillings can send droplets into the air, which puts dentists and dental staff members at increased risk of getting COVID-19. According to surveys, dentists and dental hygienists are taking steps to reduce the risk of the spread of COVID-19.

WHAT ARE DENTISTS AND THE DENTAL TEAM DOING TO HELP?

Dental offices have worked to reduce the spread of infection for a long time. For example, dental offices disinfect treatment rooms between patients, including wiping down frequently touched equipment like chairs and countertops, following guidance from the Centers for Disease Control and Prevention, and the American Dental Association. But, surveys from 2021 show that dental offices are taking extra precautions to help control the spread of the virus that causes COVID19 Dental practices reported.

• asking patients and staff members about whether they have had symptoms of COVID-19 or been around people who have had those symptoms
• encouraging social distancing between patients (by scheduling only a few patients to be in the office at a time, for example
• providing face masks for patients to wear when not being treated.

In addition, most dental practices also said they provide face masks for staff members to wear at all times. Eight of 10 dentists said they wore a special mask that offered additional protection as well as glasses or goggles to protect themselves while treating patients, which makes the office safer for everyone. Many dental practices also added physical forms of protections such as barriers, open windows to increase the flow of air, or air filters.

WHY IS REGULAR DENTAL CARE IMPORTANT?

In addition to your home oral care routine, it is important that you and your family see your dentist regularly not just in an emergency. Regular dental visits are key to reducing the risk of getting cavities, gum disease, and oral cancer.

According to the US surgeon general, tooth decay is the most common chronic childhood disease, and the risk of developing it continues into adulthood.5 Cavities and gum disease need to be prevented and treated because they can lead to tooth loss if not caught early. Your dentist will also be able to look at any signs of change in your mouth that could be linked to oral cancer.

CONCLUSION

It is important that you see your dentist regularly. Dentists are taking steps to reduce the risk of getting COVID-19 to both patients and the dental staff to help provide safe dental care. Talk to your dentist about what is being done to prevent the spread of disease.