Table 3.134.
Key considerations for dental management in radiotherapy (RTP or DXR) patients (see text)
| Management modifications* | Comments/possible complications | |
|---|---|---|
| Appropriate dental care | 1 | Before, during and after RTP |
| Pain and anxiety control | ||
| – Local anaesthesia | 1 | Avoid intraligamentary technique and epinephrine after RTP |
| – Conscious sedation | 0 | |
| – General anaesthesia | 1 | Trismus |
| Patient access and positioning | ||
| – Access to dental office | 0 | |
| – Timing of treatment | 0 | |
| – Patient positioning | 0 | |
| Treatment modification | ||
| – Oral surgery | 2 | 2 weeks before RTP |
| – Implantology | 1 | Postpone 6 months after RTP |
| – Conservative/Endodontics | 1 | Poor prognosis after RTP |
| – Fixed prosthetics | 1 | Poor prognosis after RTP |
| – Removable prosthetics | 1 | Postpone 4–6 weeks after RTP |
| – Non-surgical periodontology | 1 | 2 weeks before or 6 weeks after RTP |
| – Surgical periodontology | 1 | 2 weeks before RTP |
| Hazardous and contraindicated drugs | 0 | |
*
0 = No special considerations. 1 = Caution advised. 2 = Specialised medical advice recommended in some cases. 3 = Specialised medical advice mandatory. 4 = Only to be performed in hospital environment. 5 = Should be avoided.