Chemotherapy (a nice summary from a dental perspective)

The oral complications of chemotherapy depend upon the drugs used, the dosages, the degree of dental disease, and adjuvant radiation therapy.

Before Chemotherapy:

-conduct pretreatment oral health exam

-schedule dental tx in consultation with oncologist

-schedule oral surgery 7-10 days before pt becomes myelosuppressed (suppression of the bone marrow)

-in pts with hematologic cancers (i.e., leukemia), consult the oncologist before conducting any oral procedures; do not conduct procedures in pts who are immunosuppressed or have thrombocytopenia.

During Chemotherapy

-consult oncologist prior to any dental procedure, including prophylaxis

-ask oncologist to torder blood work 24 hours before oral surgery or other invasive procedures. Postpone them when: 1.) platelet count < 50,000/ mm3 or abnormal clotting factors are present, 2.) neutrophil count is less than 1,000/ mm3

-in pts with fever of unknown origin, check for oral source of viral, bacterial, or fungal infection

-encourage consistent oral hygiene measures

-consult oncologist about implementing the AHA endocarditis prophylactic AB regimen in pts with indwelling central venous catheters before any invasive or prophylactic dental procedures.

Category: Medical Subject Notes , Pharmacology Notes