Oral health care considerations for patients with chemotherapy:
- For patients who are to receive chemotherapy, coordinate any oral care with the medical team treating the patient.
- If the patient is to receive chemotherapy, the dentist may be asked to eliminate oral sources of infection and nonrestorable teeth.
- Complete all dental procedures at least 1 week prior to the beginning of chemotherapy.
- When providing dental care during the period the patient is receiving chemotherapy, address possible neutropenia and thrombocytopenia. The patient will experience increased immune suppression and impaired hemostasis just after receiving chemotherapy.
- Use antibiotic prophylaxis for patients with neutrophil counts 1,000 cells/mm3.
- Address oral complications due to mucositis.
Erythema and possible mucosal ulcerations mucositis may present 7-10 days after initiation of chemotherapy.
Institute alcohol-free antibacterial mouthrinses.
Provide topical analgesics for symptomatic relief.
Institute antibiotics for bacterial superinfections.
Consider antifungal and antiviral prophylaxis.
- Treat oral fungal infections, typically oral candidiasis , with topical antifungal medications. Refractory cases may necessitate systemic antifungal therapy.
- Treat viral infections, typically herpes virus infections , with systemic antiviral medications.
- Institute and reinforce compliance with a good oral hygiene protocol.
- Classifications and treatment strategies for patients with antiresorptive agent-induced osteonecrosis of the jaw (ARONJ), also known as bisphosphonate-related associated osteonecrosis of the jaws (BRONJ) have been developed.