Friday, February 14, 2014

Oncology Pocket Guide to Oral Health- Part 2


The oral complications of chemotherapy depend on the drugs selected, dosages, the degree of dental disease, and use of radiation. Chemoradiation therapy carries a significant risk for mucositis.
Before Chemotherapy

  • Refer patients to a dentist for a pretreatment oral health examination, 1 month, if possible, before cancer treatment begins.
  • Tell the dentist the treatment plan and timetable.
  • Advise the dentist if radiation therapy is also planned.
  • Allow at least 7 to 10 days of healing from oral surgical procedures before the patient begins myelosuppressive therapy.
  • Check for immunosuppression or thrombocytopenia before any oral procedures in patients with hematologic cancers.
During Chemotherapy

  • Consult with the oral health team to schedule dental treatment.
  • Conduct blood work 24 hours before any dental procedure. Postpone if
    • platelet count is less than 75,000/mm3, or abnormal clotting factors are present.
    • neutrophil count is less than 1,000/mm3.
  • Determine if there is a need for antibiotic prophylaxis before any dental procedures in patients with central venous catheters.
  • Consult the dentist to explore a possible oral source of infection when fever is of unknown origin.
  • Ask patients frequently about their oral health.
After Chemotherapy

  • Resume a regular dental recall schedule when chemotherapy is completed and all side effects, including immunosuppression, have resolved. 
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