Oral Health Program Reducing Complications Through Aggressive Pre-Treatment Measures
By Ryan Foley
A pair of Massachusetts-based doctors launched an innovative program designed to evaluate head and neck cancer patients prior to radiation and chemotherapy. Run in conjunction with Commonwealth Hematology-Oncology (CHO) and Commonwealth Atrius Cancer Center (Weymouth, MA), Dr. David Keith and Dr. Walt Kagan's program is designed to reduce oral complications through aggressive, pre-treatment measures.
When head and neck cancers are treated with radiation therapy and/or chemotherapy oral health can be greatly affected. Radiation, for example, can cause: salivary glands to become less functional or stop working completely (leading to the risk of tooth decay, yeast infection, and periodontal disease); oral sores and muscle stiffness (called fibrosis); and tissue inflammation, which can make it difficult to swallow. In worst-case scenarios, patients can develop osteoradionecrosis (loss of some or all of the jaw bone), brought on by radiation destroying normal cells and blood vessels, and thus reducing circulation to an area.
In this oral health program, at-risk patients are identified and if they do not have their own dentist who can perform an evaluation, they are referred to the Atrius Health Braintree dental practice where the necessary specialists eliminate dental infection prior to cancer treatment.
“One ounce of prevention is worth 100 pounds of cure,” said Kagan, who is president of CHO. “When you're dealing with folks afflicted with dry mouth, you see more oral infections. And a seemingly small oral infection could become life threatening, so our goal is to dramatically decrease the risk beforehand.”
Pre-radiation/chemotherapy dental treatment can run the gamut from: the dentist repairing or removing severely decayed or infected teeth that could become sources of infection, to being educated on the importance of daily upkeep, such as fluoride treatments to keep teeth free of decay.
Keith stressed the oral health program's attention to promptness, as those affiliated with the program understand the need to begin cancer treatment as soon as possible. “We want everything to flow freely for the patient,” said Keith, who is director of Dental Services at Harvard Vanguard Medical Associates. “Because we're a group practice, we can get a patient in there quickly and in a timely fashion, and not delay their radiation or chemotherapy in any way.”
The oral health program just recently launched, but according to Kagan, it's already making an impact with patients. Thanks to this coordinated approach among community health care facilities, head and neck cancer patients in Massachusetts are receiving better preventative care.
“It's all about making a patient's course of treatment as complication-free as possible,” Kagan said.