DENTAL CARE IN PREOPERATIVE ELDERLY
PATIENTS WITH CANCER OF MOUSE
*Jéssica Gazel1, José Miguel Amenábar Céspedes2, Mariele Pototski3, Nerildo Ulbrich4, Therezinha Pastre3.
1) Cirurgiã Dentista – Universidad Latina de Costa Rica. Aluna do curso de Especialização em Odontogeriatria –
UFPR, Curitiba, Paraná, [email protected], telefone: (41) 9692 4145
2) Orientador, Professor Adjunto – UFPR, Professor do curso de Especialização em Odontogeriatria – UFPR
3) Professoras do curso de Especialização em Odontogeriatria – UFPR
4) Professor Adjunto UFPR e Coordenador do curso de Especialização em Odontogeriatria – UFPR
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SUMMARY:
The increase in life expectancy as a result has brought an increase in the number of people aged over 60 years, with those above this age
have a higher risk for developing cancer. The oral cancer is a disease characterized by uncontrolled growth of abnormal cells that exhibit
aggressive behavior and uncontrollable. The dental treatment before the cancer should be as objective the removal of infected farms active,
as well as the identification and removal of potential risk factors for the onset of complications such as oral mucositis and
Osteoradionecrosis. The dental evaluation should be made in advance to treatment. The severity of complications in patients with oral
cancer can be reduced significantly when we started a strategy for maintaining oral hygiene. The treatment of teeth with prognosis
uncertain, as injuries or fractures of caries, periodontal or endodontic involvement, tooth extractions and surgeries to be performed at least
three weeks before the start of radiotherapy. Prevention would be the removal of the biofilm, topical application of fluoride, an indication of
antiseptics, antifungal oral cavity, an indication of physical therapy for prevention of trismus for prevention and treatment of mucositis, as
the use of ice and low-intensity laser. The participation of dental specialist in geriatric with knowledge and skills in the treatment of elderly
patients with cancer may reduce the risk of dental complications improving the quality of life of patients. The goal of this literature review is
to describe the participation of dental surgeons in caring for elderly patients to be subjected to radiation.
KEY WORDS: Oral complications, cancer of head and neck, radiotherapy.
Table 1. Preventive Measures
INTRODUCTION
The increase in life expectancy as a result has brought an
increase in the number of people aged over 60 years, with people
above this age are at greater risk for developing cancer. The oral
cancer is one of oral disease that affects people in this age group.
The dental treatment prior to cancer should be aimed at the
removal of active infectious foci, as well as the identification and
removal of possible risk factors for the development of
complications such as oral mucositis and osteoradionecrosis.
OBJECTIVE
The purpose of this review is to describe the participation of
dentists in the care of elderly patients undergoing radiotherapy.
Need
Treatmentmento
Prosthesis
Opening assess painização
Mouth opening
Assess Injuries , dor , desvio
Radiographic Examination
Avaliar lesões
Prophylaxis
3 weeks before radiotherapy da
radioterapia
Periodontal Treatment
Antibioticiótico
Endodontic Treatment
Medical Liaisonulta média
Restorative Treatment
Before or after treatmentou após o
tratato
Surgery and extractions
22 days before radiotherapyantes da
radioterapia
CONCLUSION
REVIEW
The oral cancer is a disease characterized by uncontrolled growth
of abnormal cells that exhibit aggressive behavior and
uncontrollable. Among the risk factors for the onset of oral cancer
may mention tobacco use, frequent alcohol consumption and
excessive exposure to sunlight (Chambers MS, Garden AS, 2006).
Oral Cancer Treatment consists of surgical removal and
radiotherapy, and the latter may cause side effects in the mouth
such as mucositis, candidiasis, dysgeusia, xerostomia, dysphagia,
soft tissue necrosis, trismus, dental caries, osteoradionecrosis
Almeida FCS, Vaccarezza GF Cazal C et al
The severity of complications in patients with oral cancer can be
significantly reduced through good dental evaluation prior to
treatment (Table 1), in order to prevent future complications. Santos
PSS Scramin RCW. In: Dental 2006
The pre-operative dental treatment in elderly patients with oral
cancer should follow the following protocol:
Patients should undergo dental evaluation prior
Remove active infectious foci
Identification
and
removal
of
possible
risk
factors
for
complications
Extractions and surgery should be performed early enough to
allow tissue healing
Using a conservative approach to dentistry.
To evaluate the patient's condition soon after the start of cancer
treatment
Encourage the patient to maintain good oral hygiene control
The service must be performed by a dental team with
experience.
BIBLIGRAFIC REFERENCES:
1. Almeida FCS, Vaccarezza GF, Cazal C et al. Avaliação odontológica de pacientes com câncer de boca pré e pós tratamento oncológico - Uma Proposta de Protocolo. Pesq Bras
Odontoped Clin Integr 2004; 4(1), 25-31.
2. Andrews N, Griffiths C. Dental complications of head and neck radiotherapy: part 2. Australian Dental Journal 2001; 46(3), 174-182.
3.Chambers MS, Garden AS, Kies MS et al. Radiation-induced xerostomia in patients with head and neck cancer: pathogenesis, impact on quality of life, and management. Head &
Neck 2004; 26, 796-807.
4.Chang DT, Sandow PR, Morris CG et al. Do pre-irradiation dental extractions reduce the risk of osteoradionecrosis of the mandible? Head & Neck 2007; 29, 528–36.
5.Huber MA, Terezhalmy GT. The head and neck radiation oncology patient. Quintessence Internacional 2003; 34(9), 693-717.
6.Jansma J, Vissink A, Spijkervet FKL et al. Protocol for the prevention and treatment or oral sequelae resulting from head and neck radiation therapy. Cancer 1992; 70(8), 217180.
7. Kielbassa AM, Hinkelbein W., Hellwig E. et al. Radiation-related damage to dentition. Lancet Oncol 2006; 7, 326−35.