Dental treatments in patients with cancer conditions

Nowadays, there is an exponential increase in the number of patients with cancer.

The chances of recovery or even cure for these patients depend very much on when the disease is detected.

Any disease that is detected early and receives treatment at an early stage has a good chance of regressing.

However, the field, which is represented by the host organism, plays an important role in modulating pathologies.

Individual reactivity is a major contributing factor in defense processes.

The health status of patients who are oncological cases is usually poor.

There is no linear evolution of pathology, with periods of remission and periods of exacerbation of symptoms.

Patients undergoing chemotherapy, hormone therapy or radiotherapy may benefit from somatic treatment under certain conditions.

Radiotherapy is applied to tumors of significant size, the aim being to shrink them with a view to subsequent removal.

Precautions to be taken into account when patients undergo radiotherapy are as follows:

Studies indicate a high risk of developing bone necrosis following radiotherapy.

Radiotherapy is known to cause bone resorption and necrosis. It is therefore recommended that extractions and other surgical maneuvers are carried out two weeks before the start of radiotherapy.

This precaution applies to tumors located in the cephalic region.

During irradiation treatment, only emergency somatic maneuvers should be carried out and care should be taken to suppress pain with minimal intervention.

Definitive dental procedures will be carried out after radiation therapy has ceased.

Chemotherapy, on the other hand, causes a decrease in the number of leukocytes, sometimes even below 5000 per cubic mm, whereas normal values place them between 5000 and 9000 per cubic mm.

The body’s defense mechanisms will no longer be able to cope with bacterial contamination.

This is why some micro-organisms that are not pathogenic in healthy individuals can become dangerous for the patient undergoing chemotherapy.

During dental treatments in these patients, care should be taken to minimize bacterial contamination.

It is even recommended that antibiotic medication be instilled in case of bleeding treatments.

The patient will have to present the blood tests that the dentist needs in order to establish the treatment plan and to get to know the oncologist for a better collaboration.

Also following chemotherapy treatments, hemoglobin values may be low.

If values drop drastically, well below the physiological limit, there is a risk of massive bleeding during dental treatments.

Therefore, bleeding treatments in the dental surgery are prohibited until the hemoglobin values allow them.

Apart from bleeding maneuvers which should be postponed until the end of cytostatic treatment, other dental treatments can be carried out.

Before starting dental treatments, it is best for the patient to inform the doctor of all the treatments they are undergoing.

It also helps to communicate with the oncologist to find out about the progress of the disease.

In recent decades, the number of patients diagnosed with cancer has increased significantly. Treatment outcomes and the chances of recovery or even cure for these patients depend largely on when the disease is detected and the quality of treatment provided. In this context, the treatment of dental conditions in cancer patients plays a crucial role in improving quality of life and therapeutic outcomes.

Health status of cancer patients

Patients suffering from cancer diseases tend to be in poor health. The course of the disease is not linear but characterized by periods of remission and exacerbation of symptoms. Treatments with chemotherapy, hormone therapy or radiotherapy can have a significant impact on the oral health of cancer patients.

Dental treatments and radiotherapy

Radiotherapy is mainly used for large tumors to reduce their size before surgery. However, there are some precautions that need to be considered when patients undergo radiotherapy treatment.

It is well known that radiotherapy can lead to bone resorption and necrosis. For this reason, it is recommended that tooth extractions and other surgical procedures are performed at least two weeks before the start of radiotherapy treatment. This precaution applies especially to tumors located in the cephalic region.

During irradiation treatment, only emergency dental procedures should be performed and special attention should be paid to pain management by minimally invasive methods. Definitive dental procedures will be carried out after completion of radiotherapy treatment.

Dental treatments and chemotherapy

On the other hand, chemotherapy can cause a decrease in the leukocyte count, in some cases even below the normal limit of 5000 to 9000/mm³. This leads to a strong depression of the immune system and the body’s defense mechanisms can no longer cope with bacterial contamination. Therefore, certain micro-organisms that are not pathogenic in healthy individuals can become dangerous for patients undergoing chemotherapy.

During dental treatment in these patients, the risk of bacterial contamination should be minimized.

Preventive measures and the use of antibiotics are recommended for dental procedures involving bleeding. The patient should provide the dentist with the necessary blood tests to establish the treatment plan and collaboration with the oncologist is essential for integrated and coordinated care.

In addition, chemotherapy can cause hemoglobin levels to drop, and in the event of a significant drop below the physiological limit, there is a risk of massive bleeding during dental procedures. For this reason, dental treatments involving bleeding should be postponed until hemoglobin values fall within normal limits.

With the exception of procedures involving bleeding, other dental treatments can be performed during chemotherapy treatment. Prior to initiating dental treatments, it is important that the patient informs the dentist of all the treatments they are undergoing and maintains constant communication with the oncologist in order to obtain up-to-date information on the progress of the disease and to ensure an individualized and effective approach to dental care.

Conclusion

Dental treatment of patients with cancer is an essential component of their medical care. Radiotherapy and chemotherapy, although vital therapeutic methods in the treatment of cancer, can affect patients’ oral health. Therefore, close collaboration between dentists and oncologists is necessary to plan and deliver appropriate dental treatments according to the stage and course of the disease.

It is important to follow specific precautions and recommendations for each individual patient, given the interactions between oncological treatments and dental treatments. By implementing a multidisciplinary and personalized approach, appropriate oral health care for cancer patients can be ensured, thus contributing to improved quality of life and therapeutic outcomes.