The overall mission of the Dentistry and Maxillofacial Prosthetics service at Roswell Park Comprehensive Cancer Center is to provide our patients with specialized care to address their dental and oral health needs. Cancer patients and survivors have complex and unique dental and oral health needs that require the expertise of dental professionals with oncology experience. Our faculty and staff of the department are uniquely trained to provide outstanding care for cancer patients throughout Western New York.
What to Expect
At Roswell Park, we have a long history of providing dental and maxillofacial services to cancer patients, particularly those affected by head and neck cancers. Our experienced dental providers at Roswell Park work closely with surgeons, medical and radiation oncologists, speech and language pathologists to ensure that you get the best care you deserve. This continued interaction between dental and medical providers is critical to successfully meet the oral health needs of our cancer patients before, during and after treatment.
Oral complications of cancer therapy are the result of:
- The surgical removal of anatomical structures of the head and neck
- The effect of chemotherapy agents on bone marrow (myelosuppression) and the direct toxic effects on the cells lining the mouth and throat
- The tissue changes associated with total body radiation or therapeutic radiation to the head and neck
- Your body’s response to allogenic (donor) bone marrow transplant (BMT) and the associated immunosuppressive drug therapy that is given
- The side effects of the drugs used as adjuvant therapy during cancer treatment
Oral complications of cancer therapy include:
- Inflammation and/or ulceration of the mucous membranes (mucositis)
- Loss of minerals from the teeth (dental demineralization) that increases tooth sensitivity
- Cavities (caused by the reduction in quality and quantity of saliva)
- Tooth loss
- Changes in or loss of your sense of taste (hypogeusia/dysgeusia)
- Poor nutritional status (malnutrition from loss of the ability or desire to eat the basic requirements to maintain nutritional health)
- Decrease in your ability to chew, speak or swallow (functional disabilities)
- Abnormal dental development (for children)
- Dry mouth (xerostomia) caused by damage to your salivary glands
Good oral care before treatment can:
- Reduce the risk and severity of oral complications
- Improve your chances to tolerate the optimal doses of cancer treatment
- Prevent oral infections that could lead to potentially fatal systemic (wide spread) infections
- Prevent or minimize complications that could jeopardize your ability to get your nutritional requirements met
- Prevent, eliminate, or control oral pain
- Prevent or reduce the incidence of bone necrosis (death) if you are receiving radiation therapy
- Preserve or improve oral health
- Improve your quality of life
What We Can Do For You
Oral and dental health in cancer patients is often affected as a result of disease and due to side effects of cancer treatments including radiation and chemotherapy. Our Dental team will monitor your oral health before, during, and after treatment to keep you healthy. We provide a full menu of general dental services, including cleaning and restoration, and will make sure your appointments take place at appropriate times in your treatment schedule.
These specialized services include:
- Comprehensive oral health assessment
- Implementation of individualized prevention and oral care protocols
- Management of existing dental conditions in cancer patients
- Prevention and management of oral complications from cancer treatment including chemotherapy and radiation
- Maxillofacial Prosthetics and Oral Rehabilitation
- Dental Management of Bone Marrow Transplant patients
Maxillofacial Prosthetics and Anaplastology Services
After treatment, patients with head & neck cancers may need prosthetics—artificial replacements, either inside or outside the mouth, for areas that were surgically removed. Prosthetics can be cosmetic (to improve the way you look) or functional (to restore your ability to speak or swallow, for example).
Roswell Park’s Maxillofacial Prosthetics team will evaluate your needs before treatment, create and custom-fit your prostheses, and work closely with your surgeons to ensure that your physical appearance and abilities will remain as close as possible to the way they were before treatment.
See a Dentist Before Treatment Begins
Your dentist is an important part of your cancer treatment. Ideally, you should see your dentist prior to the start of your anti-cancer therapies. Your cancer therapy may be less traumatic if you work with your dentist and dental hygienist to maintain good oral hygiene. This can avoid potential serious problems that can be caused by your treatments. Children need special protection for their growing teeth and facial bones.
In addition to treating poor oral hygiene, your dentist can treat any dental infections that you may not have noticed. If untreated, these infections could cause delays in your treatment. Optimally, you should visit us at least two weeks before beginning radiation or chemotherapy treatments. If you are already in treatment, see us as soon as possible.
Before your cancer treatment begins, our dentists will:
- Perform a complete oral and head and neck examination evaluating your teeth and oral tissues
- Identify and treat any existing infections, problem teeth, or problems associated with dental prosthetics
- Stabilize or eliminate potential sites of infection
- Remove orthodontic bands (if you will receive radiation therapy in that area or will receive highly stomatotoxic chemotherapy drugs)
- Evaluate your dentures and appliances for comfort and fit
- Remove any teeth that may pose a future problem to decrease the risk of serious bone infection for patients receiving head/neck radiation
- Remove loose primary teeth and eliminate any dental pathology that could lead to systemic infection and/or treatment delays for children
Our dental team will also provide instructions on:
- Good oral hygiene - special brushing and flossing techniques, how to use fluoride gels and mouth rinses, and other approaches to keep your mouth as moist and clean as possible in order to reduce the risk of infection and pain
- Techniques to help you maintain proper nutrition
- The need to avoid alcohol and tobacco