CANCER - DENTAL AND ORAL COMPLICATIONS cont. from February 2, 2011
SURGICAL ISSUES...
Patients who undergo a surgical solution to the removal of their cancer may have unique problems related to the oral structure which are now missing. While necessary in some cases, surgery can be deforming. Reconstructive surgery may be employed during the primary surgery or afterwards as a secondary procedure.
Alterations to the structures of the oral cavity and face result in complications which frequently require prosthetic reconstructure after completion of the healing process.
The use of dental and facial implants may be employed in achieving the final solution. The success rates of these osteointegrated implants, is well substantiated. Implants to replace teeth and to hold maxillofacial prosthesis, have been placed successfully even in irradiated tissues, though with lower success rates.
Mucositis, which can be caused by radiation or chemotherapy, results from the mitotic death of the basal cells of the mucosal epithelium. Portions of the gastrointestinal tract become inflamed, and red, burn-like or ulcer-like sores appear throughout the mouth.
Patients being treated with chemotherapy for tumors anywhere in their bodies, or by radiotherapy, are often plagued with mucositis. Severity depends on the quality of dental hygiene, the treatment schedule, the irradicated area and the amount of radiation given, as well as the age of the patient. Late effects can be characterized by thinning of the mucosa (the soft tissue of the oral cavity), and submucosal ulceration and necrosis. Oral mucositis is made worse by infection. The mouth can become infected, and the loss of soft tissues in the mouth can allow disease-causing organisms to enter the bloodstream. Once the mouth is affected by treatments, even the normal, good bacteria that exists as part of the natural flora of our mouth, can cause infections, as well as disease-causing organisms picked up from other sources. As the white blood cell count decreases as a result of treatments, the frequency and seriousness of infection increases. Patients who have low white blood cell counts over a long period of time, are at more risk of developing serious infections. Antibiotics used over a long period of time can change the number of normal, beneficial bacterial organisms in the mouth. Their decreased numbers may allow an excessive growth of fungi. Steroids given at the same time as treatments can also make the problem worse. Most oral infections in patients with solid tumors are caused by yeast and other fungi, while the rest are caused by viruses (such as herpes) and bacteria.
One of the more common fungal infections is Candidiasis, which colonizes the damaged mucosa.
Mucosaal healing should be complete within three to six weeks after radiation therapy, and mucositis should begin to resolve at the same time.
Radioprotectors may also be employed to reduce the negative biological effects of radiation therapy, and they may prove useful in reducing tissue toxicity. A dentist or oncologist may prescribe viscous topical anesthetics such a lidocaine to reduce discomfort, or a "Miracle Mix" (a tissue coating agent and numbing agent) to aid in oral comfort, if the symptoms are especially bad. While an uncomfortable aspect of treatment, mucositis will heal by itself shortly after treatement is completed.
to be continued....
Patients who undergo a surgical solution to the removal of their cancer may have unique problems related to the oral structure which are now missing. While necessary in some cases, surgery can be deforming. Reconstructive surgery may be employed during the primary surgery or afterwards as a secondary procedure.
Alterations to the structures of the oral cavity and face result in complications which frequently require prosthetic reconstructure after completion of the healing process.
The use of dental and facial implants may be employed in achieving the final solution. The success rates of these osteointegrated implants, is well substantiated. Implants to replace teeth and to hold maxillofacial prosthesis, have been placed successfully even in irradiated tissues, though with lower success rates.
Mucositis, which can be caused by radiation or chemotherapy, results from the mitotic death of the basal cells of the mucosal epithelium. Portions of the gastrointestinal tract become inflamed, and red, burn-like or ulcer-like sores appear throughout the mouth.
Patients being treated with chemotherapy for tumors anywhere in their bodies, or by radiotherapy, are often plagued with mucositis. Severity depends on the quality of dental hygiene, the treatment schedule, the irradicated area and the amount of radiation given, as well as the age of the patient. Late effects can be characterized by thinning of the mucosa (the soft tissue of the oral cavity), and submucosal ulceration and necrosis. Oral mucositis is made worse by infection. The mouth can become infected, and the loss of soft tissues in the mouth can allow disease-causing organisms to enter the bloodstream. Once the mouth is affected by treatments, even the normal, good bacteria that exists as part of the natural flora of our mouth, can cause infections, as well as disease-causing organisms picked up from other sources. As the white blood cell count decreases as a result of treatments, the frequency and seriousness of infection increases. Patients who have low white blood cell counts over a long period of time, are at more risk of developing serious infections. Antibiotics used over a long period of time can change the number of normal, beneficial bacterial organisms in the mouth. Their decreased numbers may allow an excessive growth of fungi. Steroids given at the same time as treatments can also make the problem worse. Most oral infections in patients with solid tumors are caused by yeast and other fungi, while the rest are caused by viruses (such as herpes) and bacteria.
One of the more common fungal infections is Candidiasis, which colonizes the damaged mucosa.
Mucosaal healing should be complete within three to six weeks after radiation therapy, and mucositis should begin to resolve at the same time.
Radioprotectors may also be employed to reduce the negative biological effects of radiation therapy, and they may prove useful in reducing tissue toxicity. A dentist or oncologist may prescribe viscous topical anesthetics such a lidocaine to reduce discomfort, or a "Miracle Mix" (a tissue coating agent and numbing agent) to aid in oral comfort, if the symptoms are especially bad. While an uncomfortable aspect of treatment, mucositis will heal by itself shortly after treatement is completed.
to be continued....
