Oral toxicities of cancer treatment

Abstract The oral cavity is a unique environment; it includes a range of different tissue types that rely on maintenance of a constant environment or homeostasis. The health of the mucosa and teeth relies on maintenance of good salivary function and also integrity of the mucosa. Toxicities associated with cancer treatments presenting in the mouth do not occur in isolation from each other or other systemic toxicities. Oral toxicities broadly include mucosal damage (mucositis), changes in salivary gland function (most notably by causing reduced salivary flow), and also can affect the integrity of bone (osteonecrosis of the jaws). These effects can have additional outcomes which affect quality of life including loss of taste, difficulty swallowing, compromised nutrition, increased dental caries, and oral infections. For most patients, the most debilitating acute toxicity is oral mucositis, and this is the main focus of this chapter. Important chronic toxicities include long-term salivary hypofunction and osteonecrosis of the jaws.