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. Author manuscript; available in PMC: 2018 Jun 22.
Published in final edited form as: J Calif Dent Assoc. 2016 Feb;44(2):85–92.

Table 1.

Summary of oral-specific side effects and management in cancer patients

Types of
side effects		 Types of
cancer
Therapy		 Common
sites
(in the
oral
cavity)		 Patient's
chief
complaints		 Clinical
manifestation		 Goals of management Management
Oral mucositis Radio/Chemo All
  • -

    Pain
  • -

    Erythematous

  • -

    Ulcerative
  • -

    To alleviate pain
  • -

    Self-limiting after cancer therapy

  • -

    Topical anesthetics (lidocaine, benzocaine, dyclonine, capsaicin)

  • -

    Avoid irritating food
Xerostomia Radio/Chemo All
  • -

    Thick or ropey saliva
  • -

    Rampant caries, decalcification
  • -

    To increase salivary flow or substitutes

  • -

    To prevent secondary pathological events (e.g., rampant caries, infections)
  • -

    Saliva substitutes (Carboxymethylcellulose, mucin, water, glycin)

  • -

    Salivary stimulants (pilocarpine, cevimeline)
Osteoradionecrosis Radio Mandible
  • -

    Non healing and/or pain at the exposed bony sites

  • -

    Unpleasant mouth smell
  • -

    Exposed bone, plaque accumulation
  • -

    To prevent further bone exposure

  • -

    To refer to specialist for surgical intervention for the Stage 3 patients
  • -

    Analgesics

  • -

    Antibiotics

    Antimicrobial rinse (0.12% Chlorhexidine)

  • -

    Avoid invasive dental procedures

  • -

    HBO chamber

  • -

    Pentoxyfylline/tocopherol
Trismus Surgical/Radio/Chemo Mastication muscles
  • -

    Cannot open mouth
  • -

    Limited mouth opening
  • -

    To identify limited mouth opening early
  • -

    Mouth opening exercise (Therabite)
Oral candidiasis Radio/Chemo All
  • -

    Burning sensation
  • -

    White patches that can rub off
  • -

    To eradicate candidiasis lesions
  • -

    Nystatin (lozenges, powder, creams, oral suspension)
Altered taste Radio/Chemo All
  • -

    Cannot taste
  • -

    None
  • -

    None
  • -

    Self-limiting after cancer therapy
MRONJ Chemo (for advanced cancer) Maxilla/mandible
  • -

    Non healing and/or pain at the exposed bony sites

  • -

    Unpleasant mouth smell
  • -

    Exposed bone, plaque accumulation
  • -

    To prevent further bone exposure

  • -

    To refer to specialist for surgical intervention for the Stage 3 patients
  • -

    Analgesics

  • -

    Antimicrobial rinse (0.12% Chlorhexidine)

  • -

    Good oral hygiene

  • -

    Avoid invasive dental procedures