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Oral Complications of Chemotherapy and Head/Neck Radiation (PDQ®)
Patient Version   Health Professional Version   En español   Last Modified: 11/06/2008
Oral Complications of Cancer Chemotherapy

Complication   Direct Risk Factor  Indirect Risk Factors 
DIC = disseminated intravascular coagulation; HSV = herpes simplex virus.
Oral mucositis Mucosal cytotoxicity Decreased local/systemic immunity: local infections, reactivation of HSV
Physical/chemical trauma
Oral infections:
Viral Decreased systemic immunity
Fungal Decreased systemic immunity
Salivary gland dysfunction
Altered oral flora (decreased bacterial flora)
Bacterial Inadequate oral hygiene Decreased systemic immunity
Mucosal breakdown Salivary gland dysfunction
Acquired pathogens
Taste dysfunction Taste receptor toxicity
Xerostomia Salivary gland toxicity Anticholinergic drugs
Neuropathies Vinca alkaloid drug use; specific drug toxicity Anemia, dental hypersensitivity, temporomandibular dysfunction/myofascial pain
Dental and skeletal growth and development (pediatric patients) Specific drug toxicity Stage of dental and skeletal maturation
Gastrointestinal mucositis causing secondary changes in oral status including taste, hygiene, and dietary intake Mucosal cytotoxicity: radiation, chemotherapy Nausea and vomiting
Hemorrhage Oral mucositis Thrombocytopenia
Physical trauma Decreased clotting factors (e.g., DIC)
Infections (e.g., HSV)


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