Both cranial radiation and chemotherapy can cause changes in the mouth, teeth, and ability to salivate. Awareness of the potential problems, combined with good preventive care, can help maintain oral health during treatment. Ask your child’s oncologist and dentist for advice about tooth care when white blood cell counts are very low. Often parents are advised to use a sponge or damp gauze to gently wipe off their child’s teeth after meals instead of brushing.

During treatment, plaque can build up rapidly on your child’s teeth, increasing the likelihood of cavities and gum infections. Take your child to the dentist for a cleaning and check-up every three to four months, as long as her blood counts are high (an absolute neutrophil count [ANC] of more than 1,000 and platelets of more than 100,000). Children with a central venous catheter should be given antibiotics before and after each visit to the dentist.

My daughter had problems with thick yellow saliva during the entire time she was treated. It coated her teeth and formed a lot of plaque. I brought her to an excellent pediatric dentist every three months to have the plaque removed. She took antibiotics half an hour before treatment and then again six hours afterward. He also put sealants on all of her molars and, even though there were many weeks when her teeth could not be brushed, she never got a cavity.

Some parents report delays in the arrival of their child’s permanent teeth. Children who receive chemotherapy or cranial radiation therapy may also have poorly developed or absent permanent teeth and short tooth roots.