Special features of oral care in cancer patients

Oral infections should be treated before the onset of cancer treatment, but extensive dental operations are not usually needed. Chemotherapy can cause neutropenia and thrombocytopenia. Blood counts are at their lowest 7-10 days after treatment and the risk of infection is at its highest. The duration of low blood-cell counts depends on the intensity of the treatment given. The blood counts of patients must always be checked before any dental procedures. Prior to invasive procedures, the hospital unit treating the cancer patient should be contacted for consultation about appropriate timing of the procedure and whether the patient’s medication should be modified. During an ongoing course of cancer treatment, invasive procedures should be performed only when absolutely necessary. If invasive dental operations are needed during chemotherapy prophylactic antibiotics are usually needed to prevent severe infections. Regular care of oral health is crucial after radiotherapy. Before the onset of radiotherapy patients are given guidance concerning preventive care and risk factors as part of specialised care. However, individual treatment plan is implemented within primary health care. Reasons for specialised consultations include tooth extractions following radiotherapy, uncontrolled caries progression and infections, problems associated with soft tissue or osteonecrosis as well as problems with prosthetic rehabilitation.