There is a risk of harmful bacteria getting into the blood stream if oral hygiene care is not adequate. This starts with a very gentle but effective tooth brushing technique.
Optimum plaque control measures may include gentle oral rinsing, increased baking soda-saline rinses, toothbrush bristles softened in hot water or the use of a super soft toothbrush. Sponge toothettes, gauze and/or cotton tipped applicators do not adequately remove plaque and should be supplemented with other measures. Dipping a sponge toothette in chlorhexidine rinse may increase effectiveness. Regular tooth brushing and flossing should resume as soon as possible. Toothbrushes should be changed frequently and/or disinfected in chlorhexidine. Be cautious about eating crunchy or sharp foods that may damage friable oral tissues. Toothpicks should not be used.
Alcohol-based mouthwashes and full-strength peroxide solutions or gels should not be used due to their drying and irritating effects. Peroxide solutions are acidic and, if used, should be followed by a neutralizing rinse, such as a bicarbonate water solution.
The preventive use of chlorhexidine rinse may be helpful in suppressing bacteria but should not replace mechanical removal of plaque with a toothbrush.
The mouth may be rinsed with a baking soda-saline solution and followed by a plain water rinse several times a day. The solution is prepared by mixing 1-2 tsp(s) of baking soda and 1/2 tsp of salt with one quart of water. The salt may be eliminated according to patient preference. The solution must not be swallowed.
Patients who experience frequent emesis (vomiting) should be encouraged to rinse thoroughly with a baking soda and water solution. Brushing the teeth without first neutralizing the gastric acids in the mouth may result in etching of the enamel.
Patients must not wear dentures while they sleep or when their dentures irritate ulcerated mucosal tissues. Dentures must be brushed daily with a denture brush and soaked in an antimicrobial cleanser or mild detergent. An effective soaking solution for dentures without metal parts is made by mixing one-teaspoon chlorine bleach, two teaspoons Calgon water softener and one cup of water. After brushing and soaking, the dentures should be rinsed well and stored in clean water or a fresh chlorhexidine solution. Patients should cleanse their tongue and oral tissues with gauze or a soft toothbrush.
Measures for preventing tooth demineralization and decay include a neutral fluoride rinse or a tooth paste with higher fluoride concentration such as Prevident 5000. It is important not to rinse for at least 30 minutes after using these products.
For more information: Contact the BC Cancer Agency at www.bccancer.bc.ca
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