Your oral care routine may not seem to be a priority if you are battling cancer, but preventing and controlling oral complications during treatment for cancer can help ease the journey.
About a third of people undergoing cancer treatment develop oral problems, including dry mouth (xerostomia), tooth decay, infections and mouth ulcers. Dirna Grobbelaar, our oral hygiene advisor, shares how to prevent and manage these common concerns.
A healthy mouth is less likely to develop oral complications. Ideally have a dental check-up and a professional clean before starting treatment, allowing two weeks or more between treatment and any dental surgery.
Dry mouth, or xerostomia, is a common side effect of radiation and many chemotherapy drugs and other medication. Saliva is the body’s natural way of keeping the mouth clean. Dry mouth encourages plaque and bacteria build up, increasing the likelihood of gum disease, decay and bad breath. Drinking water will give temporary relief and chewing gum can stimulate saliva flow. There are also products especially developed to help produce saliva, such as Sunstar GUM Hydral Moisturising Gel and Moisturising Spray that lubricate, soothe, promote soft tissue repair and create a protective coating in the mouth.
Meticulous oral care is crucial. Brush correctly at least twice a day, using a soft brush that will be gentler on sensitive gums and cleans just as effectively. Dipping the brush in warm water will further soften the bristles. You may feel extremely tired – a quality electric toothbrush, like the Philips Sonicare powerbrush will give a ‘supreme clean’ with minimum effort.
Strong tasting toothpaste may irritate the gums. Use a mild toothpaste or Olgani Naturals. If you experience bleeding gums or infection, consider a treatment paste like Sunstar GUM alcohol-free antibacterial mouthwash Gel.
Clean between the teeth daily. If you find floss too firm, try an interdental brush or gentle Sunstar GUM Soft-Picks. After eating, or for extra freshness, rinse with an alcohol-free mouthwash like Dentyl Dual Action.
If you experience nausea and vomiting, don’t brush teeth immediately afterwards; stomach acid demineralises enamel and weakens teeth. Initially just rinse your mouth with water or an alcohol-free mouthwash, then wait an hour or so before brushing.
Mouth ulcers (canker sores) expose sensitive nerve endings that can make drinking, eating, talking and cleaning your mouth painful. Don’t neglect your oral hygiene as it can promote quicker healing. Look for products like Aloclair that creates a protective film over the ulcer, for immediate relief.
Should you experience any dental or oral side effects during treatment, chat to a member of your healthcare team – your doctor, nurse or dental professional. Managing symptoms will help alleviate any pain and discomfort – a critical part of your care and recovery.
For further expert advice on looking after your health during cancer treatment, download our ‘Love Your Life, Love Your Oral Care’ booklet or email us on firstname.lastname@example.org to request your free copy. Wishing you good health!
September is National Oral Health Month
Following on from the international news reports last year that flossing is no longer necessary, should you still clean in-between? According to local dental professionals – absolutely! Says Stella Lamprecht, President of the Oral Hygienists’ Association of South Africa, “We can honestly say you only have to floss those teeth that you would like to keep. There are a lot of conflicting messages out there, but as oral hygienists, we recommend that you floss.”
The South African Dental Association (SADA) shares a similar view, “It is essential to floss or to use interdental brushes,” says Dr Nosipho Mzobe, SADA’s Head of Education. “The aim is to minimise the bacteria and micro-organisms that build up in the mouth causing tooth decay and disease. Brushing alone cannot remove it all, particularly in-between the teeth.”
Each tooth has five surfaces and brushing can reach only three. The other two surfaces are usually in close contact, allowing food debris and bacteria to get stuck and build up, above and below the gums. If this is not removed properly it will irritate the gums and eventually cause disease.
Although daily flossing or interdental cleaning is recommended, less than a third of South Africans floss on the recommended daily basis. Many people cite a lack of time or finding floss difficult to use. “It’s important to use floss correctly, otherwise you it may be ineffective or even damaging,” says Dr Mzobe. “Ask your oral hygienist or dentist to show you the correct method.”
“Cleaning in-between can be quick and easy if you have the right tools and know how,” says Ivohealth’s oral hygiene advisor Dirna Grobbelaar. She recommends using traditional string floss or a special tool. “Interdental brushes are excellent at cleaning bigger gaps, around braces, bridges or crowns. Floss on handle, like disposable GUM Easy Flossers are great for children or people with limited dexterity. If budget allows, consider power options like the Panasonic Oral Irrigator or the Sonicare AirFloss which jets a microburst of air and water between the teeth. Any of these tools can be effective; the main thing is to find a floss or tool that suits you, your mouth and your lifestyle,” says Grobbelaar.
How to ‘floss like a boss’ for a clean, fresh, healthy mouth:
- Take about 30cm of floss
- Wind the floss around your middle fingers
- Hold it floss between thumbs and index fingers
- Slide the floss in-between teeth using a gentle back-and-forth sawing action
- Fold floss around the side of a tooth in a C-shape
- Slide the floss up and down, against tooth and just under the gum line
- Repeat on the neighbouring tooth
- Pull out and repeat using a clean section of the floss
Watch the 30 second ‘how to floss’ videos, for people with normal teeth, implants and braces. There’s even a video on ‘alternatives to floss’.
Says Cape Town oral hygienist Elna van der Ham, “A clean tooth cannot be diseased. Discarding the use of dental floss would be irresponsible to say the least.”
We are proud to announce that our parent company Ivodent, has partnered with Liechtenstein-based Ivoclar Vivadent, leading manufacturers of innovative dental applications, to open a high-tech dental training and continuing education centre.
Based in Cape Town, this International Centre for Dental Education (ICDE), the first in Southern Africa, will draw dentists, dental technologists, therapists and oral hygienists to its workshop, which is equipped with the very latest in state-of-the-art training equipment.
“It is vital to keep the profession well informed,” says Ian Hockly, Technical Advisor, Ivodent, which takes on the responsibility and management of the centre, the culmination of a long collaboration between Ivodent and Ivoclar Vivadent.
“We are moving into an era of dentistry only dreamt about many years ago. Many procedures can now be done in a lab using Cadcam, and there are developments such as three-D printing and the potential of robotics.
“But advances in technologies and materials can be confusing and a facility such as this will help the profession stay abreast with developments as they happen. Continuing education is essential to place new products in the market and have the correct protocols to achieve desired predictable results,” says Hockly.
“Continuing education is essential to keep SA dental professionals up to date to serve the needs of their patients at the highest level. The centre opens exciting educational opportunities for the dental community of SA and neighbouring countries.”
For details on the Ivodent International Centre for Dental Education view www.ivodentonline.co.za.
Mouth ulcers are usually a small problem that can be a big pain, making eating, drinking or even talking uncomfortable.
About three-quarters of people will experience mouth ulcers at some point. They are often caused by a minor injury (e.g. biting the cheek accidentally) or can be recurring ‘aphthous’ ulcers, which often first appear in childhood and adolescence. Allergies can trigger mouth ulcers and babies and young children often develop them as a result of common viruses including Hand, Foot and Mouth Disease, the Coksackie Virus and Herpes Simplex (Herpetic Gingivostomatitis).
Our oral hygiene expert Dirna Grobbelaar says that whilst ulcers can be uncomfortable, they should not be a cause for too much concern. “Mouth ulcers are not contagious and usually clear up by themselves in a few days.”
She does, however, warn against neglecting one’s oral care routine. “Mouth ulcers expose sensitive nerve endings which can make cleaning your mouth uncomfortable. However, maintaining good oral hygiene at this time can promote quicker healing and will keep your teeth and gums healthy.
“After eating and before going to bed, rinse with an antibacterial mouthwash such as GUM Alcohol-free antibacterial mouthwash to help prevent the ulcer becoming infected. Continue to brush your teeth correctly twice a day, using a soft-bristled or child’s toothbrush if necessary. If your toothpaste stings try a non-foaming toothpaste like GUM Alcohol-free antibacterial mouthwash Gel or all-natural Olgani Herbal Toothpaste.
“Avoid acidic, spicy or salty foods and drinks, which may burn. Drinking with a straw may help, but be careful that hot drinks do not burn the throat.”
There are various products available at pharmacies to relieve the pain of mouth ulcers. Grobbelaar recommends Aloclair gel or spray. “Aloclair forms a barrier over the sensitive nerve endings to give immediate pain relief. The protective coating helps reduce irritation and prevent food or bacteria infecting the ulcer. This allows the ulcer to heal faster. The spray and gel are easy to apply and contain soothing Aloe Vera.”
Most mouth ulcers will last up to 10 days before clearing up naturally. If an ulcer does not heal within two to three weeks consult your doctor or dentist – oral cancer rates are on the rise globally and predicted to treble in the next generation. An ulcer can be an early indicator and it is important to rule this out.
Winter weather, colds and ‘flu can play havoc with your skin. To help avoid the ‘Rudolph’ red nose look here’s handy advice from Dirna Grobbelaar on caring for the lips, nose and skin in-between.
Constant nose blowing and cold weather can result in the delicate skin between the nose and lips becoming dry and irritated. Small cracks appear, which are exacerbated each time you wipe the nose. The area becomes chapped, red and sore.
If you are unlucky enough to catch a cold, take special care right from
the start. Keep your skin well-moisturised and apply Letibalm Nose and Lip Repair regularly. It is specially formulated to protect and help heal this area. Use only extra-soft tissues containing Aloe vera, calendula or vitamin E.
Never use rough kitchen towel or serviettes. Rather than rubbing or wiping repeatedly, just gently blot the nose. A humidifier in the room adds moisture to the air and can help prevent skin drying out. Using a nasal spray or saline solution can help hydrate the nasal passages.
You can also help hydrate and boost the skin from the inside; eat a nutritious diet containing lots of fresh fruit, vegetables and healthy fats; drink plenty of water, rooibos or herbal teas; warm drinks are soothing and can help relieve congestion; extra fluids can also help to thin mucus, relieving a stuffy nose.
Instead of long, hot showers which can dry out the skin, rather use cool or lukewarm water. Use a gentle cleanser and avoid harsh soaps or facial scrubs. And always moisturize after a bath or shower, adding a few drops of extra oil to your cream or lotion.
Chapped skin is more susceptible to infection, so make sure you wash your hands before applying moisturizer. It will also help prevent the spread of germs.
Eight skincare tips to protect the nose and lips:
- Keep the skin well-moisturised.
- Use super-soft tissues with Aloe vera or calendula.
- Gently blot the nose rather than rubbing or wiping.
- Apply Letibalm nose and lip repair balm to protect, moisturize and help heal the skin.
- Wash with cool or lukewarm water, avoiding harsh soaps or exfoliators.
- Use a saline spray to keep nasal passages moist.
- Use a humidifier to add moisture to the air.
- Drink plenty of water or herbal teas.
Letibalm Paediatric Nose and Lip Repair Balm (suitable for babies from birth), Letibalm Junior Nose and Lip Repair Fluid (for children 1 year and older) and regular Letibalm (10ml fluid or balm). Available from Dis-Chem, selected Checkers stores and independent pharmacies.
Unlike the Easter bunny, whose teeth grow continually, our adult teeth are permanent and stop growing once they have emerged from the gums. Tooth decay is the world’s most common health condition, so taking proper care is essential if you wish to keep them. Here’s expert advice on how to maintain healthy teeth, even when there are so many high-sugar Easter treats on offer.
“Dental decay occurs when bacteria in the mouth, known as plaque, breaks down food releasing acid which erodes the teeth,” says Dirna Grobbelaar, Ivohealth’s oral hygiene advisor. “If plaque is not removed it will cause tooth decay and gum disease.”
The most effective way to remove plaque is to simply clean the teeth, brushing correctly at least twice a day. Ideally use a soft-bristled brush, which won’t damage the gums, and thoroughly clean all three tooth surfaces (top, front and back). To help you brush for the full two minutes (as recommended by dentists), use a timer, an app or a brush with a built-in timer, like the Philips Sonicare powerbrush.
Daily cleaning in-between is essential and should start once the teeth begin to touch, usually from around age two. Floss is not everyone’s first choice, but these days there are plenty of options; Sunstar GUM has a huge range of interdental tools, including Soft-Picks (high-tech toothpicks), interdental brushes and floss handles. Or look an irrigator that directs jets of water between the teeth. The Panasonic Oral Irrigator is good, especially for people with implants or orthodontic braces.
Eat a nutritious, well-balanced diet. On the whole, it’s best to avoid sugary foods and drinks. When you do occasionally indulge, don’t brush immediately, as the sugar will have temporarily softened your tooth’s enamel. Rather rinse with water or an alcohol-free mouthwash, like Dentyl Dual Action, immediately after. Wait an hour or so before brushing.
How often you eat is another factor. From a dental perspective, a brief fluctuation in pH balance is better than a continual bombardment. Regular meals or a single choc-fest is actually better for your teeth than eating small snacks and treats throughout the day.
Last, but not least, a professional clean with the oral hygienist every six months and a check-up with the dentist each year will ensure any problems are picked up before they become serious.
For more expert advice speak to your dentist or oral hygienist.
Operation Smile is an international medical charity whose global network of thousands of credentialed medical volunteers from around all over the world is dedicated to helping improve the health and lives of children from more than 60 countries. Since its founding in 1982, Operation Smile has provided more than 240,000 free surgical procedures for children and young adults born with cleft lip, cleft palate and other facial deformities. To build long-term sufficiency in resource-poor environments, Operation Smile trains doctors and local medical professionals in its partner countries so that they are empowered to treat their local communities and help others around the world. Operation Smile also donates medical equipment and supplies and provides year-round medical treatment through its worldwide centres.
OPERATION SMILE SOUTH AFRICA:
Operation Smile expanded its reach to South Africa in 2006. Since inception, Operation Smile South Africa (OSSA) has conducted nearly 50 missions across Africa and currently serves as the regional hub for Central and Southern Africa. Their work includes multiple missions to the DRC, Ghana, Madagascar, Malawi, Mozambique, Namibia, South Africa and Swaziland. While they continue to expand their footprint they can look back on over 6, 000 lives changed and look forward to changing untold more in the future.
SUPPORTING OPERATION SMILE SOUTH AFRICA:
Ivohealth and Sunstar GUM are proud to support Operation Smile South Africa. In 2014 they sponsored dentist Dr Jean van Lierop and his Team AmaGumGum in the Cipla Miles for Smiles Mad Run. This February they are donating a Sunstar GUM toothbrush on behalf of every person that completes the #FreshBreathQuest.
Every 3 minutes, a child is born with a cleft lip and/or cleft palate.
A baby born with a cleft has twice the odds of dying before celebrating their first birthday.
One in every 1000 children globally is born with a cleft lip and/or cleft palate.
How fresh is your oral care knowledge? Take Sunstar GUM’s #FreshBreathQuest this February to find out.
There are awesome prizes worth over R15, 000 up for grabs! For every person that completes the quest, Sunstar GUM will donate a toothbrush to Operation Smile South Africa.
The main prize, valued at R10, 000, includes a Tsogo Sun family mini-break (worth up R7, 000) and an oral care kit worth over R3, 000, containing a Philips Sonicare powerbrush, a rechargeable Panasonic Oral Irrigator and Sunstar GUM products.
There are also 10 Sunstar GUM fresh breath kits to win (worth R539 each), packed with innovative Sunstar GUM oral care products for fresh breath and a healthy smile.
To enter, go to www.ivohealth.co.za/freshbreathquest before 28 February 2017.
Terms and conditions apply.