Management of oral complications from radiation and chemotherapy.

modulated radiation therapy), for a total of 6800 cGy. He has not had regular dental visits. Patient’s dental management will include: After cancer therapy is completed and remission or a cure is the outcome, the cancer patient should be placed on an oral recall program. Usually, the patient is seen once every one to three months during the first two years and at least every three to six months thereafter. After five years, the patient should be examined at least once per year. This recall program is important for the following reasons: A patient with cancer tends to develop additional lesions, latent metastases may develop, the initial lesions may recur, and complications related to therapy can be detected and managed. The usual long-term complications associated with the cancer and its therapy include chronic xerostomia, mucosal atrophy and erosion, loss of taste, altered bone, oral infections and related problems. Recall appointments are also important to ensure that the dentate patient continues to maintain good oral hygiene (including daily brushing, flossing, and the continued use of daily fluoride gel applications). Also, early detection of oral soft tissue and hard tissue disease can be found before inflammation and infection involve the underlying bone leading to necrosis (bone death). Salivary gland tissue is sensitive to radiation damage. Because of this, glandular tissue in the field of radiation can be permanently damaged, C L I N I C A L C A S E