This guide can be useful for patients who will be undergoing radiation to the head/neck area, beginning to take myelosuppresive drugs, or going to begin chemotherapy.

1. Step one involves getting the patient in for examination at least a month before treatment begins. Coordination with the Oncologist is helpful here to determine where the proposed radiation field will be.
   • This examination should involve a few things
     • Identification of any teeth with cavities, periodontal disease, or endodontic lesions
     • Identification and elimination of any sources of oral trauma–from partials/dentures, braces, etc
     • Patient education on foods/drinks to avoid to reduce cavity risk.
2. Once all of the patient information has been gathered, treatment of any invasive procedures need to be completed at least 14 days before starting cancer treatments
   • Extractions of questionable teeth in areas with heavy radiation
   • Root Canals of any teeth with endodontic issues that will be saved
   • SRPs
   • Prosthetic surgeries need to be completed
   • IMPORTANT: Do not commence any invasive procedures until contacting the patient’s oncologist if the cancer is Hematologic in nature.
3. Cavity and Oral Irritation Prevention:
   • Treat caries and gingival inflammation
   • Instructing patients to use a more heavy-duty fluoride toothpaste, or fluoride trays
   • Saliva inducers or supplements to fend off xerostomia
   • Setting up more frequent Hygiene recalls from every 6 months to every 2-3 months
   • Again, making sure no prostheses are rubbing irregularly on the soft tissues
4. Advice for Patients:
   • They should still be brushing and flossing, but use a soft or very soft bristled toothbrush.
   • If the brushing hurts, warm the brush up in warm water first
   • Lightly brush after every meal
   • Avoid Mouthwashes with alcohol in them
   • Join support groups with individuals who are also going through what they are.

Be sure to get in touch with your local Oncologist who may need your help in treat patients before starting cancer/immunosuppressive therapies.

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1. National Institute of Dental and Craniofacial Research. (n.d.). Dental Provider’s Oncology Pocket Guide. .S. Department of HealtH anD HUman ServiceS national institutes of Health. Retrieved March 2, 2022, from https://www.nidcr.nih.gov/sites/default/files/2017-09/oncology-guide-dental-provider_0.pdf 

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The Author of this post does not assume any liability for any injury and/or damage to persons or property as a matter of products liability, malpractice, negligence, or otherwise, or from any use or operation of any methods, instructions or ideas contained. The foregoing parties will not be liable for any direct, special, indirect, incidental, consequential, or punitive damages as a result of the reader’s use of this information.