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Supportive
Dental clearance before treatment
A dental appointment with a deadline, and one that is missed constantly.
What it is
Head and neck radiation and bone-modifying drugs both carry a risk of osteonecrosis of the jaw if dental disease is present when they start. Extractions must happen before, with time to heal.
Once radiation or a bisphosphonate has started, an extraction becomes a much bigger problem. This is one of the few oncology decisions with a hard, non-negotiable deadline.
When it is used
- Before head and neck radiotherapy
- Before starting a bisphosphonate or denosumab
- Before high-dose chemotherapy or transplant
- Where dental disease is present and treatment is planned
How the decision is made
- What must be extracted before treatment, and how many days of healing are required.
- Whether the oncology timeline can absorb that, and who is coordinating both.
- The long-term dental care plan, since radiation changes the mouth permanently.
Assessed and coordinated here; extractions and restorative work at a partner dental unit.
Who does what
What we handle, and what happens elsewhere
KPCIRC handles
- A dental assessment triggered automatically when a qualifying treatment is planned
- A written clearance with dates the oncology team can work to
- Fluoride and dry-mouth management
- Long-term dental follow-up after radiation
Performed and billed elsewhere
- Extractions, restorations and prostheses
- If radiation to the head and neck or a bone-modifying drug is being planned and nobody has mentioned your teeth, ask before it starts.
Questions to ask your own doctor
Take these with you. They work whether or not you are treated here.
- Do I need dental work before treatment?
- How long will that delay things?
- What happens if we skip it?
- How do I look after my mouth afterwards?
Support that goes with it
Where this is used
Cancers this commonly forms part of
Oral, head & neck cancer
Mouth, tongue, cheek, gum, throat, voice box and salivary gland cancers
Myeloma
Multiple myeloma
Breast cancer
Including hormone-receptor positive, HER2-positive and triple-negative disease
Prostate cancer
Cancer of the prostate gland
Leukaemia
Acute and chronic leukaemias. ALL, AML, CLL, CML
Not sure this is the right option for you?
That is exactly what a second opinion is for. Bring what you have, we will tell you what is missing and what the alternatives actually are, in writing.