Dental Aspects of Cancer Chemotherapy

Severe dental problems should be tx’d and corrected before chemotherapy or radiation is started, if possible. During cancer tx, dental/oral tx is palliative (not going to reverse the disease, just manage the condition). Dental hygiene is crucial, include fluoride treatment. If dental tx is needed, avoid subgingival scaling. Be aware of emergence of new or recurrence of oral cancer.

Most common problems are bleeding gums, oral ulcerations, xerostomia, mucositis. Manage with:

Oral pain secondary to oral lesions: 5% viscous Lidocaine

Mucositis: oral rinses; Triamcinolone, Sucralfate (Carafate – mucosal barrier, protects from acid attacks. Has iron and sugar base and can be used as a mouth rinse.

Systemic Infections: 22% of leukemia pts develop infection

Cancer Pain: most pts already on potent analgesics (oxycontin was over Rx’d as once a day sustained release, but began to be diverted. If oxycontin is prescribed now it’s a red flag to the FDA/ DEA… Remember, you can always use Tramadol (Ultram)!!! )

Xerostomia: orabase, artifical saliva, pilocarpine (muscarinic agonist… systemic effects)

Category: Medical Subject Notes , Pharmacology Notes