University of Toronto

Patients During Chemotherapy

What if I need treatment during chemotherapy?

The most appropriate time to schedule dental treatment during chemotherapy is after your blood counts have recovered. This is usually just prior to your next scheduled round or course of chemotherapy. The majority of the time, your dentist will order blood work prior to dental treatment to confirm levels are at a level reasonable for treatment.

If you do blood work, what are you looking for in the results?

Clotting Factors

Bleeding may be a complication when your platelet count is < 50,000/mm3.

Neutrophil Count

There is risk of infection when your neutrophil count is low. If you are receiving immunosuppressive chemotherapy will usually reach the lowest blood counts approximately 7 – 14 days after the start of therapy.

When your neutrophil count is extremely low but you require necessary treatment, the oncologist will be contacted and you will be provided with antibiotics.

Sometimes the combination between low clotting factors and low neutrophil count means no treatment may be rendered but when emergencies do present themselves, the dental clinic is more than happy to see you!

Normal Complete Blood Count
Red blood cells 4.2 – 6.0 million/mm3
Hemoglobin 12 – 18 g/dl
Hematocrit 36 – 52%
Platelets 150,000 – 450,000/mm3
White blood cells 4,000 – 11,000/mm3
Neutrophils (granulocytes) >2,000/mm3

Can I still brush and floss during chemotherapy?

The ultimate answer is YES; unless, your oncologist has told you to stop. AN oral hygiene program is individualized to meet YOUR needs and is modified throughout therapy according to YOUR medical status.

I have dry mouth when I’m on chemotherapy, what do I do?

Dry mouth can be temporary as the chemotherapy can cause a decrease in salivary flow. Once chemotherapy is complete, your dry mouth will slowly start to go away. During this time, there are a couple things you can do: 1. Carry a bottle of water and sip throughout the day, 2. Biotene products – which help moisturize the mouth, 3. Oral Science products – which can help moisturize the mouth as well.

If you need help figuring out which works for you, your dentist is more than happy to discuss the options available.