Welcome Dentists

You are an important part of the cancer care team !

Requirements for patients about to be treated for cancer differ from those that are required by the average patient in a dental practice. While on occasion it is permissible to observe areas of suspected infection in some patients, the rules, of which there are none incidentally, change when a patient is diagnosed with cancer.

As a guiding principle the primary goals of treatment are: treat or remove sources or potential sources of infection and clean up and promote scrupulous oral hygiene and maintenance. In general, at our institution patients will be prepared for their cancer care by our team. We do this in order to meet and exceed the clinical needs of our medical, radiation, and surgical oncologists. Additionally these preparations have to be done rapidly so as not to delay cancer treatment.

Patients are followed for a period of time but virtually all of them will return to you, their general dental practitioner for ongoing care. This is a necessity because our clinic sees 1,100 new patients per year and 12,000 patient visits per year from numerous anatomical cancer site groups. Whilst dental patients with cancer, like all patients require individualized treatment planning and care plans some GENERAL guidelines for oncology patients may include:

• Updating the medical history including drugs, central lines and blood counts at every visit and encouraging your patient to assist you by acquiring their blood counts from their oncologist.
• Becoming familiar with chemotherapy drugs or know how to access information about them from on-line sources, compendium of pharmaceuticals or texts.
• Arranging more frequent routine dental examinations and cleanings.
• Exposing more frequent radiographic examinations to look for occult disease. This differs from the non-oncology patient where radiographs should be exposed only after clinical examination.
• Recognizing “dry-mouth caries” that occurs after head and neck radiation, some chemotherapy regimens and in the elderly cancer patient and preventing it and treating it.
• Catching problems when they are small and treat them.
• Promotion of the highest level of oral hygiene and self care.
• Promotion and enforcement of the use of daily neutral pH sodium fluoride gel use in custom fluoride carriers for some patients where it has been prescribed.
• Avoidance of extractions, implants and invasive surgical procedures in a selected group of patients such as those receiving head and neck radiation, those with low blood counts and those taking intravenous bisphosphonates.