Madrid, August 10, 2020:- Oral hygiene is vital before starting cancer treatment, since infections in the mouth can not only worsen the quality of life of the patient, but also cause complications in the disease itself and therefore, affect the outcome. On the contrary, good dental hygiene will prevent many of the complications that cancer treatments cause in the mouth.
So, it is essential that cancer patients see their dentist before starting their cancer treatment in order to have an oral check-up to ensure that there is no active infection that can get worse after starting treatment.
"A cavity that has not given us any problems so far could hurt as soon as we start, for example, with chemotherapy and the number of neutrophils, or infection fighting white blood cells, is reduced," says Dr. Nestor Montesdeoca, of the Oral and Maxillofacial Surgery Service at MD Anderson Cancer Center Madrid.
Among the most common oral problems of patients undergoing chemotherapy, gum disease stands out above all and, in the case of very aggressive chemotherapies, like that used in patients with hematological tumors, ulcers and sores. The latter is especially serious because, as Dr. Montesdeoca explains, "they can jeopardize proper nutrition, which is closely related to a greater survival rate of patients".
In patients undergoing radiation therapy, it is mainly the tooth that is affected. "There can be a lot of tooth decay, even decay in all the teeth", states the doctor, who also points out there can be other complications like dry mouth or problems in the jaws. "In patients receiving radiation in the mouth, the jaw-bone can be seriously affected and it is not unusual to see cases of osteoradionecrosis, or bone death," he explains.
In addition, in patients receiving long-term treatment to control bone metastases, very common in tumors like breast or prostate cancer, damage to the jaw and maxilla bones may also occur. In patients receiving immunotherapy, the appearance of tooth decay is more common and there is often inflammation of the gums.
Cancer patients in the dentist’s office
The fundamental problem is that there is a lack of knowledge about what can and cannot be done in the mouth of a person undergoing cancer treatment. "They are patients who sometimes go a long time without finding a professional who can solve their oral problems”, admits the specialist.
Hence the importance of setting up specialized units consisting of oral and maxillofacial surgeons and dentists who are used to managing cancer patients and have easy access to their oncologists and the patient's medical records. "Units prepared to deal with these patients are necessary," stresses Dr. Montesdeoca.
"As a hospital fully dedicated to the treatment of cancer patients, MD Anderson Madrid is a pioneering center in the incorporation of specialized units in this field", explains the doctor, who believes that these units should be extended to all centers, above all to treat patients at higher risk of oral complications - patients with head and neck tumors receiving radiation therapy, patients with hematological tumors and patients with bone metastases.
In addition to providing adequate, personalized treatment to each patient, these specialized units are prepared to prevent and provide scheduled or urgent treatment for any oral complications that may come up during cancer treatment. They also provide information on proper oral hygiene habits to maintain a healthy mouth during cancer treatment. The objective is that, once the disease is overcome, the patient can continue their life with the highest possible quality of life.
Telemedicine in oral and maxillofacial surgery
During lockdown for the COVID-19 pandemic, tele-consultation for dental and maxillofacial emergencies has been of great help to our patients. Video consultation continues to be very useful particularly for the treatment of dental pain, discomfort in the temporomandibular joint, the hinge connecting the jaw and the skull, and in the diagnosis of skin tumors on the face.