|
| Treatment before chemotherapy | Treatment during chemotherapy | Treatment after chemotherapy |
|
| The dentist should consult the oncologist to determine the current condition of the patient and the type of treatment planned. | The oncologist should be consulted in order to know the degree of immune suppression of the patient. | The dentist should consult the oncologist to determine immune competence. |
|
(i) Exhaustive examination of the oral cavity: discard periapical lesions and/or bone alterations and the evaluation of periodontal health.
(ii) Denture fitting should be checked, with readjustment or removal of those prostheses that prove trauma.
(iii) Radiological study: intraoral (periapical and bitewing) and panoramic. | Treatment of the complications of chemotherapy (mucositis, xerostomia). | (i) Insist on the need for routine systematic oral hygiene.
(ii) Use of chlorhexidine rinses and fluorization. |
|
| General prophylactic measures: tartar removal, dental fluorization, and rinses with 0.12% chlorhexidine. | Continued patient reminder of the need to maintain strict dental hygiene is indicated, with the added use of chlorhexidine rinses and fluorization. | |
|
| The patient should be informed of the complications of treatment. | (i) Analgesics: paracetamol/metamizol.
(ii) No NSAID.
(iii) Antibiotics: dose adjustment is required according to the observed creatinine clearance values in patients with kidney problems.
| |
|
Teeth that are nonviable or present a poor prognosis should be removed:
(1) minor surgery: at least two weeks before chemotherapy.
(2) major surgery: 4–6 weeks before chemotherapy. | No elective dental treatment should be carried out.
Only emergency dental care. | Elective dental treatment. |
|
