Cancer and Your Mouth: Why should you think about the dentist if you have cancer
Inundated with appointments, one can easily forget about visiting the dentist when you are diagnosed with cancer. Nonetheless, it is important that you don’t!
Wait why?
Cancer therapy affects the entire human body, including the oral cavity.
Poor oral hygiene and health has been linked to an increased risk of developing oral side effects associated with cancer treatment regimens as well as an increased severity of these conditions.
Thus, it is highly recommended that patients visit a dentist with dental oncology training prior to receiving any cancer therapy to help reduce the risk of developing these oral complications.
When should I visit the dentist?
Ideally, the best time to visit a dental oncologist is two weeks prior to commencing cancer therapy. In the initial visit, the dentist will perform an evaluation and perform any necessary treatment needed prior to receiving cancer therapy. If invasive dental procedures are required, such as extractions, it is ideal to allow 10 days to two weeks of healing time.
What should my dentist know about my cancer history?
When visiting a dentist, it is important to inform your dentist of any underlying medical conditions as these conditions may affect your dental treatment. Additionally, you want to inform your dentist about your cancer history (stage and grade) as well as the proposed therapy and start date. If you will be receiving head and/or neck radiation therapy, you should tell your dentist where the radiation treatment will be delivered. Finally, you should tell your dentist if you have received anti-resorptive medications (bisphosphonate therapy, denosumab, bevacizumab, sunitinib).
What should my oncologist know about my dental history?
Your dentist should inform your oncologist about the presence of any acute dental or periodontal infections as well as the presence of any dental decay (cavities). Furthermore, your dentist should inform your oncologist of any teeth that require extractions as the timing of extractions may affect the your cancer treatment timeline.
If I am undergoing chemotherapy what counts are safe for dental procedures?
Although a dental oncologist is concerned with all of your blood counts, he/she is most concerned with two counts: your platelet count and your absolute neutrophil count.
Platelets
Platelets are the blood cells required for forming blood clots.
The minimum recommended platelet count is 50,000 cells/mm3 for invasive dental procedures such as extractions or other surgical procedures.
If dental treatment is absolutely necessary, and your counts are below 50,000 cells/mm3, your dentist may speak with your oncologist and recommend a blood transfusion an hour prior to receiving your dental treatment.
Neutrophils
Neutrophils comprise the greatest number of white blood cells in mammals and are essential for defending the human body against infections. Neutrophils may be measured on a complete blood count report as ‘neutrophil count,’ which is often recorded as a percentage, and ‘absolute neutrophil count.’ The absolute neutrophil count (ANC) is a more reliable measurement than the neutrophil count as it accounts for both the segmented neutrophils (mature neutrophils) and the bands (the immature neutrophils).
The minimum ANC recommended for dental treatment without antibiotic prophylaxis is 1.0 k/mm3. In other words, dental treatment should only be performed on patients with an ANC of at least 1.0 k/mm3.
So what’s the bottom line?
- Visit a dentist when you are undergoing cancer therapy
- Tell your dentist about your ANC (at least 1.0 K before dental treatment) and platelet (at least 50 K before dental treatment) count before undergoing dental treatment
Originally posted at laurenlevidmd.com
