Table 2. 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 oral mucosal and/or systemic immunity | |
| Salivary gland dysfunction | ||
| Altered oral flora (decreased bacterial flora) | ||
| Bacterial | Inadequate oral hygiene | Decreased oral mucosal and/or systemic immunity |
| Mucosal breakdown | Salivary gland dysfunction | |
| Acquired pathogens | ||
| Taste dysfunction | Taste receptor toxicity | |
| Xerostomia | Salivary gland toxicity | Anticholinergic drugs |
| Neuropathies | Vinca alkaloid, thalidomide, bortezomib drug use; risk for specific drug toxicity varies | 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) | ||
