The sense of taste is essential to the health and psychological well-being of an individual. Taste disorders can range from lack of taste, to distortion of taste, to reduced ability to taste. Any disorder in taste perception can lead to conditions like malnutrition and consumption of poisonous food substances. The cause may be due to disease, drugs, radiation treatment, or ageing; or it may result from unknown causes. Various treatment methods have been used to improve taste sensation. These include the use of zinc compounds, pilocarpine, alpha lipoic acid, transcranial magnetic stimulation, ginkgo biloba and acupuncture. Continue reading
Sore mouth and ulcers (oral mucositis) is a side effect of treatment for cancer including chemotherapy, head and neck radiotherapy, and targeted therapy, affecting over 75% of high-risk patients. Ulcers can lead to severe pain and difficulty with eating and drinking. Sufferers may need strong painkillers, possibly have to go into hospital and even be fed through a tube into their stomach or their veins. These complications may disrupt their cancer therapy, meaning they are not receiving the best treatment, which may reduce survival. Cancer patients have weakened immune systems due to their treatment and are less able to fight infections. An ulcer is an open wound and there is a risk that bacteria can enter the body leading to infection or sepsis (a dangerous inflammatory reaction of the body to infection).
Mouth soreness and ulcers can be costly to healthcare systems, yet there are few preventive interventions or treatments proven to be beneficial. Cytokines and growth factors may help the regeneration of cells lining the mouth, thus preventing or reducing oral mucositis and its negative effects.
Medication-related osteonecrosis of the jaw (MRONJ) is severe bone damage in the jaw bone that occurs in some people as an adverse reaction to certain medicines commonly used in the treatment of cancer and osteoporosis (a disease that makes bones fragile). It is a painful condition that can be difficult to treat. MRONJ occurs rarely in people taking some medicines for osteoporosis. However, in people receiving these drugs at higher doses for cancer-related conditions, the risk of MRONJ may be higher and has been reported to occur in up to 5 in 100 individuals. It is essential to obtain better treatments for people who have MRONJ. It is also important to identify effective preventive measures to reduce the risk of MRONJ. Continue reading
Problems with saliva production and salivary glands are a significant and mostly permanent side effect for people after radiotherapy treatment to the head and neck. When this occurs the condition is known as dry mouth or xerostomia. Dry mouth is not measurable and is a subjective or personal expression of how the mouth feels. It can have other causes and is a consequence of the production of less saliva or by the consistency of saliva. The rate of flow of saliva in an individual’s mouth however can be measured. People who have dry mouth have a reduced quality of life. They can experience issues with taste and general discomfort, difficulties chewing, swallowing and speaking as well as tooth decay, thrush and other infections of the mouth. A wide range of drugs that work in different ways have been used to try and prevent problems with salivary glands caused by radiotherapy. Unfortunately there is currently not enough evidence to show which drugs or which type of drugs are most effective. Continue reading
Burning mouth syndrome (BMS) is a common painful condition. Symptoms include burning, dryness or uncomfortable sensations in the mouth and changes to taste. There is no obvious underlying medical or dental cause, however scientific research suggests that BMS may be caused by underlying damage to the nerves. BMS is often a persistent and long term condition, which can lead to a reduced quality of life (QoL). There are many treatments available including drugs for treating psychological conditions and increasing saliva production, protective barriers, and treatments applied to the mouth surface. Continue reading
Oral leukoplakia is a white patch formed in the mouth lining that cannot be rubbed off. It often does not hurt and may go unnoticed for years. People with leukoplakia develop oral cancer more often than people without it. Preventing this is critical; rates of oral cancer survival longer than five years after diagnosis are low. Drugs, surgery and other therapies have been tried for treatment of oral leukoplakia. Medical and complementary treatments can be locally applied (i.e. directly onto the white patch) or systemic (affecting the whole body, e.g. taken as a pill). Continue reading
Bisphosphonates are drugs very similar to pyrophosphate (a normal substance found in bone). They are used to lessen symptoms and complications due to the spread of cancer to the bones, and to prevent and treat fragile bones in osteoporosis (a conditon where tiny holes in the bones makes them brittle). These drugs can cause a rare but serious condition called bisphosphonate-related osteonecrosis of the jaw or ‘BRONJ’. BRONJ affects the healing of bone damage by interrupting the process of removing dead bone and laying down new bone. When this happens, parts or all of the jaw bone becomes friable (a bit like chalk), and eventually this dead bone can be exposed. This makes it difficult for people to eat, speak or brush their teeth, and it often causes severe pain. Many different treatments are currently used for BRONJ. They can be categorised as non-invasive treatments (such as antibiotics and mouth rinses), surgical approaches or “add-on” treatments used to enhance usual care (for example, ozone therapy or use of blood plasma that has been enriched with platelets). Different treatments may be combined. Continue reading