A diagnosis of cancer embarks a patient and his or her family on a journey down long roads of uncountable doctor visits, unknown terminology, and unwanted uncertainty. Few experiences leave their indelible mark on health, relationships, and spirituality as deeply as cancer. Often, in the midst of this storm, oral health and dental care are overlooked or placed on a back burner – until there is a problem.
Patients undergoing treatment for cancer present with a unique set of medical concerns and potential complications. Immunosuppression, radiation therapy, and cytotoxic drugs can cause painful and debilitating effects on the oral mucosa, increase the risk of infection, and alter the normal healing process expected after dental
procedures. Unfortunately, these experiences are realized to some degree or another by patients with all types of cancer – not just patients with oral cancer. To care for these needs is the scope of dental oncology.
Dental oncology is a focus of dentistry dedicated to meeting the unique dental and oral health care needs that arise as a result of cancer therapy. It is an area of oral medicine devoted to improving the well-being and quality of life of people battling cancer. Dental oncology goes beyond the scope of general dental treatment to include management of the soft tissues of the mouth and care for oral side effects specific to cancer therapy. A dental professional knowledgeable in dental oncology plays an important role throughout cancer treatment by preventing and managing mouth sores, dental needs, oral pain and infections. As a member of the patient’s oncology care team, the dental oncologist communicates directly with the medical oncologist, radiation oncologist and other team members to provide optimal comprehensive care before, during, and after cancer treatments.
Ideally, a patient’s relationship with a dental professional begins as soon as possible after receiving the diagnosis of cancer. Most of the present-day treatments for cancer involve the administration of cytotoxic drugs, radiation, myelosuppressive treatments or some combination thereof. Having a baseline assessment completed before the
implementation of immunosuppressive therapies allows the dental professional to have a pre-treatment reference point to compare oral and systemic health at future visits.
For the newly diagnosed patient with cancer who has not received regular dental and oral health care, a prompt visit to the dentist’s office also allows for immediate attention to unaddressed periodontal issues and unresolved dental needs before immunosuppression begins. During cancer treatments, bacterial components of calculus, dental plaque and oral biofilm can easily become vehicles for bacteria getting into the blood stream or the source of oral infections. Properly addressing these oral health concerns at this pre-treatment stage can prevent or significantly reduce the severity of oral issues that could complicate or even interrupt the patient’s cancer treatment schedule.
Sometimes, it is not possible for an individual to see a dental oncologist before beginning cancer therapy. There is still much that can be done at each stage of the battle to help diminish the severity of side effects and reduce the risk of infection.
Even for the cancer survivor, a dental oncologist should be a member of an ongoing care
team. This is especially true for the head or neck cancer survivors or any patient that received bisphosphonate therapy for bone metastases.
Baylor Charles A. Sammons Cancer Center is fortunate to have an outpatient dental clinic. The dentists and hygienist are experienced in caring for patients battling cancer and managing their unique oral health care needs. The mission of the dental clinic at Sammons is to ready the patient for cancer treatment and minimize oral complications or problems throughout cancer care. Patient services include pretreatment evaluations; dental cleanings, including periodontal therapy; root canal therapy; extractions; and therapeutic dentistry, including fillings. With the focus on cancer care, the medical staff of the dental clinic can manage soft tissue problems and other oral issues specific to cancer therapy, including musocitis, osteonecrosis, and severe dry mouth.
Furthermore, the hygienist is a certified tobacco cessation expert and offers effective programs for those who want to quit smoking.
For more information about the program, call a Patient Navigation specialist at 214.820.3535 to learn more about making a dental oncology professional part of your cancer care team.
This post was contributed by Dennis M. Abbott, D.D.S. Dr. Abbott is a member of the dental oncology medical staff at Baylor Charles A. Sammons Cancer Center and Baylor University Medical Center in Dallas. He is also the founder and CEO of Dental Oncology Professionals of North Texas, an oral medicine practice dedicated to meeting the unique dental and oral health needs of patients battling cancer. Dr. Abbott holds a Bachelor of Arts in biology from Rice University in Houston, and is an honor graduate of Baylor College of Dentistry. After dental school, he studied immunology, microbiology, and oral medicine at the School of Dental Medicine, State University of New York at Buffalo. Dr. Abbott serves as a consultant to the national American Cancer Society in the development of oral monitoring guidelines for post-treatment cancer survivors and is a board trustee for the Jack T. Clark Foundation, a nonprofit organization dedicated to easing the suffering from oral conditions related to cancer and cancer therapy.