Endodontic Dental Treatment in Oncology Patients

Indications, Safety and Appropriateness of Endodontic Dental Treatment in Oncology Patients

Endodontic treatment, commonly known as root canal treatment or therapy, is an extremely well understood, predictable safe, and highly successful treatment that is used as an alternative to tooth extraction. In involves removal of the soft tissue on the inside of the tooth and the cleaning, shaping, and disinfection of the nerve space and its subsequent sealing with an inert cement and rubber filling.

Oncology patients have a number of factors associated with their overall health, that can adversely effect the outcome of tooth extraction; therefore it is highly desirable to try to save these teeth by performing endodontic treatment whenever possible.

Generally during chemotherapy when blood counts can change, radiation, and subsequent to or preceding certain types of surgical resective procedures, patients are often in a compromised position regarding their own ability to successfully undergo an extraction, making such treatment a risky endeavor in an already weakened patient.

Often after radiation, for example, the blood supply to the tooth and surrounding bone is diminished, which could adversely affect the body’s ability to heal after extraction. This is also true as a result of certain drugs used to treat some bone cancer. Chemotherapy can lead to a drop in certain blood cells that are important in dealing with infection, thus decreasing overall immunity.

Local factors such as bone removal can leave the jawbone more susceptible to fracture which can only compromise the strength of the bone and its ability to withstand an extraction.

Thus whenever possible, root canal therapy is the treatment of choice over extraction in just about every case.