Chemotherapy can damage rapidly dividing cells of the mouth and throat, causing painful sores and ulcers.
These can prevent normal eating and drinking, increasing the risk of other problems such as malnutrition and dehydration.
Mouth and throat sores are not commonly associated with regular chemotherapy for retinoblastoma. They are more frequently associated with very intensive chemotherapy and bone marrow transplant.
However, they should always be considered a potential risk for any child receiving chemotherapy.
Chemotherapy can reduce a child’s ability to produce saliva. Cavities and gum infections are more likely to occur if plaque is allowed to build up rapidly on your child’s teeth. The growth of your child’s teeth may also be delayed.
Help Your Child
After each meal, ensure your child’s teeth, gums and tongue are gently cleaned using a soft toothbrush or damp cloth. This will keep her mouth as clean and free of bacteria as possible.
If your child has a sore mouth or throat, serve bland, soft food or soups.
Put food through a blender if possible.
Encourage your child to use a straw for drinks and blender-processed food.
Check your child’s mouth daily for sores or ulcers, and seek advice from the oncologist if you suspect any problems.
The doctor may recommend an antiseptic rinse if your child is receiving high dose chemotherapy or has problems with mouth sores. He may also prescribe an anaesthetic spray if your child has associated pain.
Dental Care
Your child may be referred to a hospital dentist by the oncologist. If this is not the case, seek advice from the oncologist and ask your child’s dentist to formulate an appropriate dental plan for the duration of chemotherapy and follow-up care.
So long as your child’s blood counts are high enough (ANC above 1000 and platelets above 100,000mm3), take her to the dentist every 3 – 4 months for a thorough check-up and cleaning.
If your child has a central line, she should be given antibiotics before and after each visit to the dentist to prevent infection.
Seek advice on practical dental care during very low blood counts before this situation arises. Consult both the oncologist and dentist for information.