The oral adverse effects of chemotherapy may complicate dental treatment in patients with cancer.1 Systemic adverse effects, for instance immuno suppression, are likely to complicate endodontic treatment or surgery. Taking a pre-treatment medical history is essential to obtain information about the drugs being used to treat the cancer. You should also ask if the patient has had radiotherapy, particularly in the region of the head and neck.
Dental treatment needs to be planned with care. The risks of post-operative infection and delayed wound healing should be minimised. This could include antibiotic surgical prophylaxis. An increased risk of infection from periodontal disease and its treatment should be anticipated. Stomatitis may occur with or without oral ulceration and may be relieved by topical steroid therapy (triamcinolone).
Where possible, a comprehensive oral and dental examination should be made and any infection treated before chemotherapy begins. Following chemotherapy provision should be made for dentate patients, to have a regular preventive dentistry program to minimise the need for invasive dental treatment.
Dental management of any patient, young or old, can be complicated by chemotherapy. Where there is any doubt concerning the effects of medication used or precautions needed, dentists should discuss the case with the patient's oncologist.
In June Dr John Dowden, the Editor of Australian Prescriber, received an outstanding service award from the Drug Information Association (DIA). The presentation ceremony took place at this year's annual meeting of the DIA in California. Dr Dowden accepted the award in front of an audience of approximately 7000 people in the San Diego Convention Centre.