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Dental care in cancer treatment
A mandatory step in head-and-neck treatment, and the one most often skipped.
What it is
Radiation to the head and neck permanently changes the jaw's blood supply and the mouth's ability to heal. A tooth extracted after radiation can lead to osteoradionecrosis, bone that does not heal. Extracted before, it usually heals normally.
That is why pre-radiation dental clearance is not paperwork. It is a treatment decision with a deadline, and it has to happen before the radiation referral leaves the building.
When it is used
- Before any radiotherapy involving the mouth, jaw or salivary glands
- Before high-dose chemotherapy and before transplant conditioning
- During treatment, for mucositis, infection, dry mouth and pain
- After treatment, for long-term dental care that is now permanently different
How the decision is made
- Which teeth need attention before treatment starts, and how much time that needs.
- Whether treatment can begin before dental work is complete, and what the trade-off is.
- A long-term preventive plan, fluoride, saliva management and review intervals, because the risk does not end when radiation does.
In our own dental and oral medicine clinic. Complex oral surgery and implants beyond scope are referred.
Who does what
What we handle, and what happens elsewhere
KPCIRC handles
- Pre-radiation dental clearance, booked before the radiation referral
- Extraction and restorative work with treatment timelines in mind
- Mucositis and dry-mouth management during treatment
- Oral cancer screening, this clinic is one of our highest-yield detection routes
- Long-term dental review after treatment
Performed and billed elsewhere
- Complex maxillofacial surgery
- Implants beyond our scope
- Orthodontics
- After head-and-neck radiation, never let a dentist extract a tooth without telling them you have had radiation to that area. It changes everything about how the extraction should be handled.
Questions to ask your own doctor
Take these with you. They work whether or not you are treated here.
- Do I need dental clearance before radiation, and how long will it take?
- Which teeth are at risk, and what happens if we do nothing?
- What do I use for dry mouth, and for how long?
- How often should I be seen after treatment ends?
Support that goes with it
Where this is used
Cancers this commonly forms part of
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.