(PR78) Dental Considerations for Patients Undergoing Cancer Therapy

Abstract: Many cancer therapy modalities cause side effects in the oral cavity, decreasing patient’s quality of life. Common side effects include: xerostomia, oral mucositis, jaw osteonecrosis, infections in the mouth , trismus, pain, dysgeusia, dysesthesia, and more. Some side effects can become chronic even after treatment ends. Currently, there is a lack in standardized, evidence-based guidelines on providing dental care for patients before, during, and after cancer therapy. Through literature review, this study aims to establish guidelines specifically tailored to each cancer treatment modality, in order to effectively alleviate oral side effects and increase quality of life. Overall, head and neck radiation therapy, hematopoietic stem cell transplantation (HSCT), and chemotherapy are the cancer treatment modalities that are most commonly associated with oral side effects. For patients undergoing these treatments, standard of care practices should be established, such as proper dental examination, prophylaxis, and active disease treatments following specific timeline prior to initiation of cancer therapy. In addition, routine dental exam, premedication, and cancer surveillance post-cancer therapy can prevent systemic infection and detect potential malignant transformations. Orthodontic and endodontic considerations are recommended in certain cases. Clinical guidelines specific to each cancer therapy modality, such as addressing graft versus host disease (GVHD) in HSCT, are also proposed in this study. Throughout the journey of caring for cancer patients, it is essential to maintain communication and collaboration with the medical team, develop anticipatory treatment plan maximizing patient quality of life, and treat each patient with empathy, as one human to another.