Monday, August 20, 2018
Just like everything else in life, people procrastinate when it comes to their oral health, and the consequences can be worse than you might have imagined. There are situations in which we are forced to make hard decisions of whether or not to retain teeth that might be otherwise savable. In most cases, these terrible decisions involve oropharyngeal cancer. Approximately 52,000 people in the United States will be diagnosed with this horrible and sometimes disfiguring cancer this year. Of those, approximately 20% will die of that cancer. Radiation treatment is one of the primary means of treating cancers of the head and neck, and the side effects can be very debilitating. As dentists, there are several consequences of radiation treatment that we deal with. In most cases, the salivary glands are a casualty of radiation, which leads to greatly reduced saliva flow, dry mouth (xerostomia) and subsequent root decay and periodontal (gum) disease. The other major side effect is perhaps the worst of all. Radiation causes the bone of the jaws to be far less resilient when it comes to repairing itself following any type of trauma. Trauma includes oral surgery such as root canal treatments, implant placement, periodontal surgery, and tooth extraction. Even the rubbing of a denture on the gum tissue can cause major problems that can lead too a disease process known as osteoradionecrosis. This causes bone loss that can spread to encompass most or all of the bone in the upper or lower jaw. In order to prevent this, we generally extract unhealthy teeth prior to the radiation treatment that would otherwise be savable, because after the radiation treatment, a tooth requiring removal could cause osteonecrosis and the horrible consequences associated with it. For people who have kept up with their oral care prior to their cancer diagnosis, this is pretty much a non-issue. For those who have decay and/or gum disease, it means the loss of the teeth involved and difficulty ever replacing those teeth. Any oncologist will tell you that the overall health of a patient entering cancer treatment has a major impact on the success of that treatment and the quality of life afterwards. Do yourself a favor and do what it takes to keep your body and your mouth in a healthy state. We can't predict what the future holds for us, but going into that future as healthy as possible can only make it better.