Rather than calling it oncological dentistry, perhaps it would be more accurate to call it dentistry for oncological patients.
The existence of tumors that affect the craniofacial massif, and therefore the patient’s mouth, leads to the application of radiotherapy treatments, and the existence of loss of substance of the jaws and face that entails the need for dental and facial prostheses.
How do cancer treatments affect the structures of the mouth?
Cancer treatments when they are radiotherapeutic generate a decrease and slowing down of the cellular functioning of tissues, which results in low salivation and an increase of biofilm on the teeth. Likewise, dentin has less capacity for repair and the appearance and progression of caries increases. The oral mucosa also slows down its metabolism and becomes more sensitive and weak to trauma generated by chewing food.
When the treatment is surgical, tissue resection results in total or partial loss of the jaws, jaw, tongue or lips. Nowadays, reconstructive surgery of the patient is attempted on the same day of the resection, but sometimes it is not possible.
In these cases in which surgery does not allow reconstruction of the loss of substance, it is in these cases that we rely on the realization of maxillofacial prostheses that allow, at least, to recover the lost function, not only masticatory, but also phonatory and aesthetic. This type of maxillofacial prosthesis can be external or internal, with or without teeth, for palate and/or jaw, and even reach ocular and facial plastic prostheses. They are usually removable and the use of osseointegrated implants allows their fixation and retention.
What type of dental implants can be placed in people who have suffered from cancer? What should be taken into account when working with them?
Any type of implants currently used in dentistry can be used in an oncology patient, although sometimes we must use customized designs that involve the design and application of maxillofacial surgeons. With dental and facial implants the most important thing is the possibility of keeping the tissues surrounding the implant healthy, which can be difficult and aggravated by the existence of chemotherapy and radiotherapy treatments.
What oral complications are the most frequent during chemotherapy and radiotherapy? How can they be treated?
Almost the most frequent are derived from radiotherapy since chemotherapy patients are not treated until they are considered able to be at home or are allowed to go to the dentist.
Therefore, we will say that in radiotherapy we find patients with trismus or impossibility or limitation to open the mouth, pain in the tongue, swollen mucous membranes, lack of saliva, superinfections and caries, which translates into pain when swallowing, mucosal ulcers and difficulty to heal these ulcers.