Oral complications of local and systemic cancer treatment.

Acute and chronic complications of oral tissues and changes in physiologic process frequently accompany cancer therapies. Mucositis is a common dose-limiting complication in patients receiving systemic cancer chemotherapy, bone marrow transplantation, and local irradiation for tumors in the head and neck area. In addition, mucosal ulcerations may become portals for the invasion of pathogens that in turn may be life threatening. Oral environment changes and salivary gland dysfunction cause an increase in dental caries and periodontal disease in dentulous patients who receive radiation therapy in and around the oral cavity. Some of these therapy-related oral complications can be controlled by pretherapy modification of the oral environment, such as elimination of acute and potential dental and periodontal foci of pathoses, patient participation in oral care, and awareness by dentists and oncologists that cancer patients require specific oral care. Prevention and management of oral mucositis, as well as prevention and control of dental pathoses, are still problems that need further investigation.