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Tooth and Root Damage From Chemotherapy

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After all these blogs, there’s still one side effect I haven’t talked about.

john Smelcer image

My doctors and nurses always reminded me that chemotherapy kills fast-growing cells, like cancer. Many parts of our body are composed of fast-growing cells, like our hair and our fingernails, both of which are observably effected by the harsh chemicals. But did you know that the nerves to your teeth are fast-growing? Not the teeth themselves, but the gums and roots (nerves). I learned this the hard way. It took several rounds of chemotherapy over an equal number of months, but at some point (halfway) my teeth began to be sensitive to hot and cold. By the time I was on my sixth and last hospitalization for chemo, I was experiencing excruciating pain, mostly in my molars (top and bottom). Eating an ice cream cone became torture.

I knew the pain in my teeth was related to the chemotherapy. I always had pretty good teeth, More than once, after watching me grimace in pain from something I was eating or drinking, my wife insisted I should go see a dentist, that I may have a cavity. But I knew it wasn’t a cavity. I understood that as the months and months of treatment piled up in my body, so too did the deleterious effects of the chemo. Like a snowball rolling downhill, the effects became more and more, worse and worse, But that awareness also gave me hope, hope that it would go away someday. After all, as the saying goes, “What goes up must come down.” I knew that once I was done with my treatment (i.e. no more chemotherapy) that the damaged tooth nerves/roots would slowly be replaced with new healthy cells. I was correct. Half a year after I rang the bell on the oncology ward, the pain in my lower molars went away. After another month or so, the upper left molars no longer hurt. Today, as I write this while sipping a hot cup of coffee, the pain is almost gone on the last remaining damaged tooth on my right side.

I was lucky. As far as I can tell, nine months since my last infusion of chemo, my teeth have mostly healed. Just as my weight and hair and strength have returned, my mouth may also be back to normal soon. But the damage to the roots and nerves of teeth can have lasting impact, increasing the likelihood of cavities. The weakened teeth may be more susceptive to decay. It’s important to be aware and to have your dentist check your teeth sometime after treatment for cancer.

During my six months of chemotherapy for Stage 2 non-Hodgkin’s Lymphoma, I wrote poems about my experiences and feelings. I wrote almost a hundred poems. The collected poems are now published in Running from the Reaper: Poems from an Impatient Cancer Survivor. On a sunny day in early February, 2023, I rang the bell. I beat cancer. If you ask me, it was close at times. I was never certain of the outcome. One of the last poems I wrote in the book is my advice to others.

HOW TO SURVIVE CANCER

I barely made it through the punishing chemotherapy.

I’m still here—

weak and wasted, but here.

You want my advice on how to survive cancer?

Here it is:

Breathe in and out.

Don’t die.

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Dr. Lauren Pinter-Brown