Oral Medicine Service

Request an Appointment

If you need oral care, your Fred Hutch provider will refer you to us. You can also contact us directly.

Phone: 206.606.1333

Blood and marrow transplant, other cancer treatments and cancer itself can all cause oral (mouth) and/or dental problems like mouth sores, dry mouth and a higher risk of infection. At Fred Hutch Cancer Center’s Oral Medicine Service, we manage these oral and dental issues, offering procedures, treatments, medications and personalized care plans to help reduce symptoms and improve quality of life. 

About the Oral Medicine Service

In 1975, Fred Hutch established the very first oral oncology care service in the world. At that time, the service was mainly for patients who were having treatment in the Fred Hutch Bone and Marrow Transplant Program. The program is well-known for completing the world’s first successful bone marrow transplant in 1959, and today, the Fred Hutch Blood and Marrow Program continues to be an international leader. 

Today, while the Fred Hutch Oral Medicine Service continues to serve the oral needs of transplant patients, we have also expanded to provide supportive care for people dealing with oral and orofacial complications of cancer, hematologic and immune disorders or the treatment of these conditions.

Who We Treat

Patients Receiving Blood and Marrow Transplant

At the Oral Medicine Service, we see patients before a blood and marrow transplant to lower the risk of post-transplant infections. After the transplant, we also help diagnose, treat and prevent (when we can) post-transplant oral complications like oral infections, dry mouth and graft-vs.-host disease (GVHD). 

Before a Blood and Marrow Transplant

We encourage patients to see their dentist before beginning treatment. The dentist should do a complete exam to look for cavities, periodontal (gum) disease and other problems. 

Ideally, all oral infections should be treated and healed before the patient starts treatment, because oral and dental issues can lead to infection after a blood and marrow transplant. 

If your dentist has questions or concerns, they should call us at 206.606.1333. Our staff will send the call to one of our physicians or the attending physician on call. 

Patients with Oral Cancer or Lesions that May Be Oral Cancer

We help to diagnose oral cancer and other oral lesions that might be cancerous. We also help reduce any complications related to the treatment of these conditions that might happen. 

Before Head and Neck Radiation 

We recommend that patients with oral, oropharyngeal or other head and neck cancers see their dentist before having head and neck radiation, if this is part of their treatment plan. The dentist should do a complete exam to look for cavities, periodontal (gum) disease and other problems. 

Ideally, all oral infections should be treated and healed before beginning therapy to reduce the risk of oral infection and other complications, including osteoradionecrosis (bone damage from radiation) of the jaw.

Patients with Non-Oral-Cancer or Treatment-Related Issues

Oral complications are common in cancer therapy, and our team helps diagnose and treat many of these conditions. Examples include oral mucositis, “oral sores” and ulcerations, dry mouth and salivary problems, oral candidiasis (“thrush”), bleeding gums, osteonecrosis (bone damage) of the jaw and dental problems that can happen during cancer therapy.

What to Expect 

While mouth sores and dry mouth are common side effects of cancer treatment, in many cases they can be effectively treated and managed. We can provide you with personalized care and treatments to help with these symptoms and improve your comfort. 


Your First Appointment 

Your first appointment will be at our clinic at Fred Hutch Cancer Center – South Lake Union. During this visit, we will do a complete oral exam, go over your medical history and talk with you about your treatment plan. This helps us identify any possible oral health issues and make a personalized care plan to manage and prevent any oral and/or dental side effects you may have. We will also give you information about keeping up with oral hygiene and managing symptoms at home.
 

Care Options

Oral complications related to cancer therapy are often managed by multidisciplinary teams with specialists in different areas who provide specific types of help.

For example, if someone is having trouble speaking and/or swallowing, they will often see the Fred Hutch otolaryngology team along with team members from the Speech and Language Pathology Department.

As part of treating oral sores and oral sensitivities, we may also work with registered dietitians. If a person is having mouth pain, a dietitian can help them choose foods and drinks that are more comfortable for them to eat and drink as well as helping to make sure they are getting the right nutrition.
 

What You Can Do at Home 

Brushing

Keeping up with good daily oral hygiene is very important during cancer treatment to prevent infections and complications.

We recommend brushing twice a day using a soft toothbrush and fluoride toothpaste. If the toothpaste stings or is uncomfortable, try a non-mint-flavored toothpaste or brush with plain water or a saline (salt water) solution until your mouth feels better. Either a manual or electric toothbrush is OK; just make sure the brush is soft. Rinse your toothbrush after each use and let it air-dry before you use it again. You can use warm soapy water to clean your toothbrush.

Flossing

Removing plaque between your teeth is important because it not only lowers your risk for gingival (gum) infection, but also lowers inflammation, which is a major factor in bleeding gums. You should always floss gently, so you do not hurt your gums. To do this, gently slide the floss between your teeth, curve it into a "C" shape around the tooth, and move it up and down to clean the sides of the teeth without forcing it against your gums. Flossers (floss holders) may be easier to use when your mouth is sore and are also OK to use. 

If you need help, we can show you how to gently and carefully brush and floss.

Frequently Asked Questions (FAQ)

Brush your teeth gently twice a day with a soft-bristled toothbrush and use a fluoride toothpaste. Floss gently once a day to keep your mouth clean. Do not use mouthwashes with alcohol, because they can be irritating. We can recommend gentle mouth rinses and techniques that will be best for you.

Some dental procedures may need to be postponed during cancer treatment, but routine oral care and certain treatments are often necessary and safe when coordinated with your oncology team. It's important to tell us about your cancer treatment so we can work with your provider in case you need any dental procedures. 

If you are having trouble swallowing or speaking as a result of cancer or cancer treatment, we can offer supportive care and treatment options to help manage these symptoms. We may recommend exercises, medications or referrals to other specialists, like a speech therapist, to improve your quality of life.

Your Care Team

Meet the caring, dedicated people who take care of you and your family at Fred Hutch.