مقالات پذیرفته شده در هفتمین کنگره بین المللی زیست پزشکی
The needing of dentistry in patients with head and neck cancers
The needing of dentistry in patients with head and neck cancers
Shirin Anghozeh Yazdi,1Mohammadhassan Lotfalizadeh,2,*Sepehr Kobravi,3
1. Dental Student Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran 2. Board Certificate Oral and Maxillofacial Radiologist, North Khorasan University of Medical Sciences (NKUMS), Bojnurd, Iran 3. Department of Oral and Maxillofacial Surgery, Faculty of Dentistry (Khorasgan), Isfahan Azad University, Isfahan, Iran
Introduction: The risk of acute dental infections and life-threatening systemic infections during immunosuppression is greater in patients with chronic dental disease and poor oral hygiene. In the fight against odontogenic infections, oncology centers have applied an empiric approach, and the implementation of dental protocols for early cancer treatment was often involved. Fluoride therapy has been raised as a vital preventive way against caries following radiation and is effective in reducing the risk of dental caries in this special group. In addition, the benefits of using fluoride, observed initially in the common population, were extrapolated, and its helpful role in the treatment procedure of dental caries in people who received neck and head radiation was investigated.
The main goal of this study is to search the entire literature for information on periodontal disease, dental caries, and precancerous tooth cleaning protocols in cancer patients receiving neck and head chemotherapy, radiation therapy, or cooperative treatment.
Methods: PubMed, Google Scholar, Scopus, and ScienceDirect are universally recognized databases that were used to retrieve published information (between 2000 and 2022). In the search strategy, published literature dealing with dental treatment procedures for cancer patients who have received neck and head radiotherapy and chemotherapy was downloaded and retrieved.
Specific keywords such as “neck and head cancers”, “radiation therapy ”, “chemotherapy”, “dental follicle cells”, “precancerous lesions”, “fluoride therapy”, “head and neck cancers”, “radiation-induced xerostomia”, “xerostomia “ were used. 500 studies were funded. Based on abstracts, 470 studies were eliminated, and about 30 went for full-reading texts. Twenty-eight relevant articles with complete abstracts were included in the study.
Results: The article states that cancer patients who received neck and head radiotherapy were at higher risk of developing tooth decay during and after treatment. The dental treatment included restorative, endodontic, extractive, and prophylactic procedures based on the clinician's assessment of the patient's clinical and radiographic condition, the time available before cancer treatment initiation, and the patient's immune status. The article also states that fluoride therapy was the best choice for the prevention of decay in these patients, and several studies have investigated the benefits of using fluoride for controlling the average of caries in the general population. In conclusion, cancer patients who underwent neck and head radiotherapy are at higher risk of caries development due to radiation-induced damage to the hole salivary glands in the oral cavity, which leads to the development of dry mouth or xerostomia.
Conclusion: Overall, managing the dental health of patients undergoing neck and head radiation therapy is a challenging and vital element of their overall healthcare and welfare.
Dental treatment guidelines for these patients commonly encompass managing dental caries, administering root canal therapy if feasible, extracting non-viable teeth, and applying preventive dental care, often taking into account scaling and root preparation.
The choice of dental treatment to be administered is contingent on multiple influences, for example, the assessment of the dental and radiographic state by the clinicians, the periodontal and pulpal status, the time remaining before cancer treatment initiation, and the immune condition of the patient.