Myth or Truth: Is Flossing Safe During Cancer Therapy?

Drs. Debbie Saunders and Joel Epstein dispel the myth about the safety of flossing for patients undergoing cancer therapy.

Dr. Debbie Saunders is a Dentist and Medical Director of the Dental Oncology Program, Health Science North, in the North East Cancer Center. She is also Assistant Professor in the Norther Ontario School of Medicine. 

Dr. Joel Epstein is Professor and Medical Director Cancer dentistry at the Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Health System in Los Angeles and the Division of Otolaryngology and Head and Neck Surgery in City of Hope. 

Highlights

Flossing is fundamental in reducing inflammation in the gingival tissues. It is important for patients to continue flossing during cancer therapy and to reduce or remove the risk of gingivitis. This also helps to prevent uncontrolled bleeding from the gums in patients with thrombocytopenia (low platelet counts).

Studies have shown that effective removal of bacterial plaque reduces inflammation and does not induce bacteremia in compromised patients. Generally speaking, patients that are able to floss in an atraumatic fashion should continue flossing. However, if bleeding occurs for longer than 2 minutes while flossing, patients should discontinue and be referred to dental oncology. Similarly, patients who have never flossed or are unable to floss in an atraumatic manner should not begin flossing at the time they are having cancer treatment. If patients have a platelet count of 20 or less, flossing is not recommended until the platelet levels rise.

Resources

• Dysgeusia in Adults with Cancer: Screening and Assessment
• Symptom Management Guide-to-Practice: Oral Care
• Intra-Oral Infections in Adults with Cancer: Screening and Assessment
• Mucositis in Adults with Cancer: Screening and Assessment
• Symptom Management Pocket Guides: ORAL CARE
• Xerostomia in Adults with Cancer: Screening and Assessment
• Oral Care Plans

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