Table 3.24.
Key considerations in dental management in cancer (head and neck) (see text)
| Management modifications* | Comments/possible complications | |
|---|---|---|
| Risk assessment | 2 |
|
| Pain and anxiety control | ||
| – Local anaesthesia | 1 | Altered anatomy |
| – Conscious sedation | 1 | Compromised airway |
| – General anaesthesia | 1 | |
| Patient access and positioning | ||
| – Access to dental office | 0 | |
| – Timing of treatment | 0 | |
| – Patient positioning | 1 | |
| Treatment modification | ||
| – Oral surgery | 2 | Major indication |
| Osteochemonecrosis due to bisphosphonates | ||
| – Implantology | 2 | Care if patient treated with bisphosphonates |
| – Conservative/Endodontics | 1 | |
| – Fixed prosthetics | 1 | |
| – Removable prosthetics | 1 | Maxillary obturator is recommended; mandibular reconstruction is mandatory |
| – Non-surgical periodontology | 1 | |
| – Surgical periodontology | 2 | Care if patient treated with bisphosphonates |
| 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.