Cyclophosphamide

Oral health effects

• Oral mucositis

  Painful, ulcerative inflammation of the oral mucosa that can limit nutrition and serve as a portal for infection.

  Mechanism: Direct cytotoxic injury to rapidly dividing mucosal epithelium.

  Clinical management: Pre-treatment dental clearance, basic oral care protocols, bland rinses, topical analgesia; oncology coordination. Cryotherapy helps with some bolus regimens.

• Infection & bleeding risk (myelosuppression)

  Neutropenia and thrombocytopenia raise the risk of oral infection and bleeding.

  Clinical management: Defer elective invasive care during neutropenic/thrombocytopenic nadirs; coordinate counts with oncology.

• Taste change (dysgeusia)

  Dysgeusia and hypogeusia are listed in postmarketing reports (label), adding to the high background rate of chemotherapy-related taste change.

  Clinical management: Reassure that taste changes are common during cancer therapy and usually improve after treatment; rule out oral candidiasis and dry mouth, keep the mouth clean (bland rinses), and suggest dietitian input if eating is affected.