Oral and dental management of the cancer patient: prevention and treatment of complications

Abstract

Aggressive cancer therapy places patients at greater risk for oral complications and treatment-related consequences. Unfortunately, prevention and/or treatment of such oral sequelae has become an often overlooked priority of the treatment team. We describe a philosophy of management of the cancer patient that specifically emphasizes the prevention and treatment of oral complications associated with cancer therapy. These concepts and principles are based on treatment protocols and ongoing clinical research at the University of Texas M.D. Anderson Cancer Center in Houston, Texas.

Oral Complications and Management Strategies for Patients Undergoing Cancer Therapy

“…While the necessity of dental clearance is debatable and empirical guidelines vary from center to center, assessment, treatment, and prevention of any preexisting pathological condition make up an important aspect of the overall treatment outcome in cancer patients [6, 7]. Unfortunately, priority is often given to the more “life-threatening” condition that is cancer, and administering oral care has become an activity frequently neglected [8, 9].…”

Prophylaxis with povidone-iodine against induction of oral mucositis by radiochemotherapy

“…Compliance with oral care procedures is the key to maintaining the relative health of the mucosal tissues and the effectiveness of locally applied topical oral agents. Such topical medications should be nonirritating and nondehydrating [7]. In our study patients tolerated the dilution of povidone-iodine used very well, although it is irritating to the mucosa .…”

“…Oral complications associated with cancer therapy can be classified into the following general types: stomatitis, infection, bleeding, mucositis, pain, loss of function, and xerostomia [7,40]. They are commonly associated with preexisting conditions that significantly affect the initiation, augmentation, and persistence of this complication in the oral cavity.…”

“…They are commonly associated with preexisting conditions that significantly affect the initiation, augmentation, and persistence of this complication in the oral cavity. Three anatomical sites in the oral cavity are the focus for these complications: mucosa, periodontium, and teeth [7,42].…”

Efficacy of Pilocarpine and Bromhexine in Improving Radiotherapy-induced Xerostomia

“…1 The problems experienced by patients may include a persistent dry or burning sensation, eating difficulties, diminution in taste acuity, discomfort during speaking, mucosal infections, denture intolerance and bacterial sialadenitis. 2 These symptoms reflect not only the mechanical function (moisture, irrigation and lubrication) of saliva, but also its buffering properties. 3 …”