Objective. To evaluate the effectiveness of three-month fluoride varnish application on radiation caries and dental sensitivity and to assess compliance to three-month fluoride varnish application. Materials and Methods. 190 irradiated head and neck cancer patients were randomly selected and reviewed retrospectively. Oral prophylaxis, fluoride varnish application, and treatment of dental caries were done prior to radiation therapy. Patients were followed up at every three months for dental evaluation and fluoride varnish application. Decayed-missing-filling-teeth indices, dental sensitivity, and compliance to fluoride varnish application were noted for fifteen months and analyzed statistically. Results. Significant increase in decayed-missing-filling-teeth index was seen at nine (P = 0.028), twelve (P = 0.003) and fifteen (P = 0.002) months follow-up. However, the rate of increase in decayed-missing-filling-teeth indices was 1.64/month which is less than the rate mentioned in the literature (2.5/month). There was no significant effect of sex (P = 0.952) and surgery (P = 0.672) on radiation caries, but site of disease (P = 0.038) and radiation dose (P = 0.015) were found to have statistically significant effect. Dental sensitivity decreased from 39% at 3 months to 25% at 15 months followup. 99% compliance to fluoride varnish application was seen till six months followup which decreased to 46% at fifteen months. Conclusion. Three-month fluoride varnish application is effective in decreasing radiation caries and sensitivity and has good compliance.
The technician by virtue of his profession plays an important role in fabricating silicone tongue prosthesis for a total glossectomy patient. The technician, with his skills and specialized knowledge in handling material, plays a valuable role as a member of the oncology team. A patient with total glossectomy can be rehabilitated by silicone tongue prosthesis as an aid to improve his speech and swallowing. This paper describes the technical steps involved in fabricating a silicone tongue prosthesis for an edentulous total glossectomy patient.
Patients afflicted with Bell's palsy are faced with both functional and esthetic impairment. Prominent among these are the inability to close the eyelids and abnormal facial appearance, with concomitant difficulty in eating, drinking and speaking. Rehabilitation of such patients can be achieved by a multispecialty approach, with the prosthodontist functioning as an integral part of the treatment team. This article describes a simple and effective approach to restore the blinking reflex of the upper eyelid with custom gold implant and facial esthetics with cheek support prosthesis.
Aim. To assess quality of life and speech after rehabilitation with implant-retained dental prosthesis in head and neck cancer patients.Material and Methods. Twenty-six patients who were diagnosed with tumour of the maxilla and mandible were selected for rehabilitation with implant-retained dental prosthesis following resection and reconstructive surgery. They were evaluated for quality of life (EORTC QLQ-C30 and H-N35 questionnaires, version 3), speech, and swallowing (questionnaire and Dr. Speech software, version 4) before implant treatment and at six-, twelve-, and eighteen-month followup. Statistical analysis of quality of life, speech, and swallowing for different duration of their preoperative status was done. Quality of life, speech, and swallowing in grafted and native groups and radiated and nonradiated groups were also compared.Results. Quality of life was statistically significant in scale of pain, speech, and trouble with social eating, pain killers, and weight loss. It was insignificant when radiated and nonradiated or grafted and native jaw groups were compared. Improvement in movement of the tongue, swallowing ability, salivation taste, and intelligibility of speech was also observed.Conclusion. The surgical treatment of head and neck cancers with microvascular surgery and dental rehabilitation with implants restores function, esthetics, and patient’s well-being.
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