Patients with Head and Neck Cancer Need Comprehensive Dental Treatment
The Blende Dental Group focuses on treating patients with special needs, including those with head and neck cancer. Patients with head and neck cancer are often diagnosed in the later stages of the disease. This is due to a lack of initial symptoms and difficulty visualizing the process in the throat, nasal or oral cavities, even by a dentist.
When cancer is diagnosed and biopsied by a dentist, an oral surgeon or an ENT surgeon, appropriate imaging will be done (CT scan, MRI, PET scan, etc.) to delineate the primary cancer and collateral lymph nodes. It is very important that head and neck cancer patients undergo a pre-radiation examination by an oral surgeon and a general dentist familiar with this condition prior to the initiation of XRT. This dental team can help prevent many of the extremely detrimental damaging effects of radiation on hard and soft tissue, especially the jaws and salivary glands.
Three types of treatment are considered for head and neck cancer patients: surgical excision, radiation treatment (XRT) chemotherapy, or any combination of these. If the cancer is extensive and/or distant metastases are present, surgical excision may not be the best option, and XRT/chemotherapy may be used as an alternative course of therapy. Radiation therapy that kills cancer cells often also damages collateral healthy cells, like osteoclasts of the jawbone and salivary gland cells. Since there is decreased local immunity (radiation-induced), the possibility of devastating complications is high. Radiation-induced dry mouth (xerostomia) and osteoradionecrosis (ORN) (similar to the osteomyelitis of the jaw) are examples of these complications, which can result in the loss of large amounts of jawbone.
Treatment by the oral surgeon/general dentist team should include: a comprehensive examination; extraction of all non-restorable teeth that will fall within the target zone of the radiation beam; treatment of all other teeth with curettage and scaling; fabrication of temporary or permanent restorations; and custom fluoride trays. These treatments should help to protect the patient from the side effects of radiation treatment and possible complications. The chance of detrimental effects occurring is greatly reduced if dental treatment is complete before radiation therapy.