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MANAGEMENT
UNDERGOING
RADIOTHERAPY
OR
CHEMOTHERAPY
RADIATION EFFECTS ON
ORAL MUCOSA
Pain
Loss of taste
RADIATION EFFECTS ON
MANDIBULAR MOBILITY
TRISMU
S
RADIATION EFFECTS ON
SALIVARY GLANDS
Sleeping difficulty
Nutritional compromises
Decreased resistance to loss of tooth structure from atrition, abrasion and erosion
Rampant (radiation) caries decay around the entire circumference of the cervical
portion
TREATMENT OF XEROSTOMIA
Water
STIMULATION
FDA approved:
RADIATION EFFECTS ON
BONE
EVALUATION OF
DENTITION BEFORE
SHOULD TEETH BE EXTRACTED? Consideration:
RADIOTHERAPY
Immediacy of Radiotherapy
Delayed RT: may give time for dental management, need to work closely with
the patient
Radiation Location
The more salivary glands and bone involved, the more severe xerostomia and
vascular compromise
Radiation dose
METHOD OF PERFORMING
PREIRRADIATION
EXTRACTIONS
No categoric answer
Flouride application
TOOTH EXTRACTION
AFTER RADIOTHERAPY
USE OF DENTAL
IMPLANTS IN IRRADIATED
PATIENTS
The more radiation delivered, the higher the failure rate for
endosseous implants
DENTAL MANAGEMENT OF
PATIENTS RECEIVING SYSTEMIC
CHEMOTHERAPY FOR
MALIGNANT DISEASE
EFFECTS ON ORAL
MUCOSA
EFFECTS ON
HEMATOPOIETIC SYSTEM
EFFECTS ON ORAL
MICROBIOLOGY
Chemotherapeutic agents
Immunosuppressive side effect overgrowth of
microbes, superinfection with gram (-) bacili,
and opportunistic infections
GENERAL DENTAL
MANAGEMENT
Prophylaxis
Fluoride treatment
Necessary scaling
GENERAL DENTAL
MANAGEMENT
WBC 2000/mm3
Platelet 50.000/mm3
TREATMENT OF ORAL
CANDIDIASIS
BIPHOSPHONATES
May be asymptomatic
Restorative dentistry
Attempts to cover exposed bone with flaps may cause more bone
exposure and worsening of symptoms with risk of pathologic fracture
THANK