Gerald S. Fine, D.D.S.

   Oral and Maxillofacial Surgery

Brookline Office
Tel: 617-731-6060

Our commitment is to provide you the highest standard of oral and maxillofacial surgery in a professional manner.

Dental Care for the Cancer Patient

A few months ago, I wrote about osteoradionecrosis (O.R.N.) and the irradiated patient. That letter prompted several questions from dentists who have patients undergoing radiotherapy for head and neck cancer in their practice.

When radiotherapy is chosen for the treatment of head and neck cancers, the oral cavity and salivary glands may be exposed to high radiation doses and respond dramatically. Radiation therapy can produce mucositis, alter the function of the salivary glands and increase the risk of mucosal infection. Remodeling of the bone and soft tissue is compromised, and infection and necrosis may result.

Before beginning therapy, consultation with a dental team knowledgeable about the care required by patients undergoing head and neck cancer treatment is advisable to address oral conditions that may precipitate oral complications. The patient should receive a complete radiographic examination, dental intervention and close monitoring of all the teeth, especially those in the field of radiation. Meticulous oral hygiene cannot be over emphasized. The most common chronic complications are xerostomia, mucosal sensitivity, and increased risk of cavities, candidiasis, and osteoradionecrosis.

MANAGEMENT

Before Radiation During Radiation After Radiation
Definitive Diagnosis Good Oral Hygiene Care    Complete Dental
Medical History Daily Topical Fluorides Maintain dental integrity
Good Oral Hygiene Saline Rinses Frequent dental visits
Complete Dental Exam    Lip Moisturizer  
Radiographic Exam Passive jaw opening exercises to reduce Trismus

  
Before undergoing radiation therapy there should be treatment planning with the dental team to minimize the oral morbidity of these patients.

‍Gerald S. Fine, D.D.S.
Practice limited to oral & maxillofacial surgery‍