Clinical Programs, Head and Neck Oncology Program
DENTAL INFORMATION
Dental management plays an integral role in the treatment of the HNSCC patient. Oral complications are seen with surgery, radiation therapy and chemotherapy. Complications can be acute and resolve after treatment is complete or become chronic and lifelong. Therefore, a dentist must follow the patient closely before, during and after the radiation and/or chemotherapy.
Pre-therapy dental appointments should establish a dentition that the patient will be able to maintain for the rest of his or her life. The evaluation should consider the patient's previous interest in oral health, as well as current motivation to comply with a rigorous preventive oral health program. The appointment will focus on gathering medical/dental history as well and the presence of dental disease. Teeth that are diseased or in poor condition may need to be extracted prior to radiation or chemo therapy.
Dental management during therapy consists mainly of no elective dental treatment and fabrication of fluoride trays for remaining teeth. Palliative care is given for acute oral side effects, and excellent patient home care is strongly encouraged. Following completion of all therapy and resolution of all acute oral side effects, the patient should be placed on a dental recall schedule at intervals appropriate to the maintenance of excellent oral status. Maxillofacial prosthodontic appliances may be constructed after the mucositis has resolved and integrity of the oral tissues has been re-established. For the comprehensive management of major dental breakdown, or of significant prosthetic need, referral to a maxillofacial prosthodontist with experience in the treatment of cancer patients is indicated when possible. Glenn Minsley, DMD heads the team of prosthodontists available at UNC. Other dentists in this department are Lauren Patten, DDS; Janet Southerland, DDS, PhD, MPH; and Jennifer Webster-Cyriaque DDS, PhD.
| From University of North Carolina, Ear, Nose and Throat,
Clinical Programs (www.unc-ent.org), Clinical Programs, Head and Neck Oncology Program |
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