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DENTAL CARE IN PREOPERATIVE ELDERLY PATIENTS WITH CANCER OF MOUSE *Jéssica Gazel 1, José Miguel Amenábar Céspedes 2, Mariele Pototski 3, Nerildo Ulbrich.

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Presentation on theme: "DENTAL CARE IN PREOPERATIVE ELDERLY PATIENTS WITH CANCER OF MOUSE *Jéssica Gazel 1, José Miguel Amenábar Céspedes 2, Mariele Pototski 3, Nerildo Ulbrich."— Presentation transcript:

1 DENTAL CARE IN PREOPERATIVE ELDERLY PATIENTS WITH CANCER OF MOUSE *Jéssica Gazel 1, José Miguel Amenábar Céspedes 2, Mariele Pototski 3, Nerildo Ulbrich 4, Therezinha Pastre 3. 1)Cirurgiã Dentista – Universidad Latina de Costa Rica. Aluna do curso de Especialização em Odontogeriatria – UFPR, Curitiba, Paraná, telefone: (41) ) Orientador, Professor Adjunto – UFPR, Professor do curso de Especialização em Odontogeriatria – UFPR 3) Professoras do curso de Especialização em Odontogeriatria – UFPR 4) Professor Adjunto UFPR e Coordenador do curso de Especialização em Odontogeriatria – UFPR SUMMARY: The increase in life expectancy as a result has brought an increase in the number of people aged over 60 years, with those above this age have a higher risk for developing cancer. The oral cancer is a disease characterized by uncontrolled growth of abnormal cells that exhibit aggressive behavior and uncontrollable. The dental treatment before the cancer should be as objective the removal of infected farms active, as well as the identification and removal of potential risk factors for the onset of complications such as oral mucositis and Osteoradionecrosis. The dental evaluation should be made in advance to treatment. The severity of complications in patients with oral cancer can be reduced significantly when we started a strategy for maintaining oral hygiene. The treatment of teeth with prognosis uncertain, as injuries or fractures of caries, periodontal or endodontic involvement, tooth extractions and surgeries to be performed at least three weeks before the start of radiotherapy. Prevention would be the removal of the biofilm, topical application of fluoride, an indication of antiseptics, antifungal oral cavity, an indication of physical therapy for prevention of trismus for prevention and treatment of mucositis, as the use of ice and low-intensity laser. The participation of dental specialist in geriatric with knowledge and skills in the treatment of elderly patients with cancer may reduce the risk of dental complications improving the quality of life of patients. The goal of this literature review is to describe the participation of dental surgeons in caring for elderly patients to be subjected to radiation. KEY WORDS: Oral complications, cancer of head and neck, radiotherap y. BIBLIGRAFIC REFERENCES: 1. Almeida FCS, Vaccarezza GF, Cazal C et al. Avaliação odontológica de pacientes com câncer de boca pré e pós tratamento oncológico - Uma Proposta de Protocolo. Pesq Bras Odontoped Clin Integr 2004; 4(1), Andrews N, Griffiths C. Dental complications of head and neck radiotherapy: part 2. Australian Dental Journal 2001; 46(3), Chambers MS, Garden AS, Kies MS et al. Radiation-induced xerostomia in patients with head and neck cancer: pathogenesis, impact on quality of life, and management. Head & Neck 2004; 26, Chang DT, Sandow PR, Morris CG et al. Do pre-irradiation dental extractions reduce the risk of osteoradionecrosis of the mandible? Head & Neck 2007; 29, 528–36. 5.Huber MA, Terezhalmy GT. The head and neck radiation oncology patient. Quintessence Internacional 2003; 34(9), Jansma J, Vissink A, Spijkervet FKL et al. Protocol for the prevention and treatment or oral sequelae resulting from head and neck radiation therapy. Cancer 1992; 70(8), Kielbassa AM, Hinkelbein W., Hellwig E. et al. Radiation-related damage to dentition. Lancet Oncol 2006; 7, Santos PSS, Scramin RCW. In: Odontologia – Resultados e Integração. Complicações Bucais da Radioterapia e Quimioterapia. Ed. Artes Médicas 2008; INTRODUCTION The increase in life expectancy as a result has brought an increase in the number of people aged over 60 years, with people above this age are at greater risk for developing cancer. The oral cancer is one of oral disease that affects people in this age group. The dental treatment prior to cancer should be aimed at the removal of active infectious foci, as well as the identification and removal of possible risk factors for the development of complications such as oral mucositis and osteoradionecrosis. OBJECTIVE The purpose of this review is to describe the participation of dentists in the care of elderly patients undergoing radiotherapy. REVIEW The oral cancer is a disease characterized by uncontrolled growth of abnormal cells that exhibit aggressive behavior and uncontrollable. Among the risk factors for the onset of oral cancer may mention tobacco use, frequent alcohol consumption and excessive exposure to sunlight (Chambers MS, Garden AS, 2006). Oral Cancer Treatment consists of surgical removal and radiotherapy, and the latter may cause side effects in the mouth such as mucositis, candidiasis, dysgeusia, xerostomia, dysphagia, soft tissue necrosis, trismus, dental caries, osteoradionecrosis Almeida FCS, Vaccarezza GF Cazal C et al The severity of complications in patients with oral cancer can be significantly reduced through good dental evaluation prior to treatment (Table 1), in order to prevent future complications. Santos PSS Scramin RCW. In: Dental 2006 CONCLUSION The pre-operative dental treatment in elderly patients with oral cancer should follow the following protocol: Patients should undergo dental evaluation prior Remove active infectious foci Identification and removal of possible risk factors for complications Extractions and surgery should be performed early enough to allow tissue healing Using a conservative approach to dentistry. To evaluate the patient's condition soon after the start of cancer treatment Encourage the patient to maintain good oral hygiene control The service must be performed by a dental team with experience. NecessidadeTratamento PróteseHigienização Abertura da bocaAvaliar abertura, dor, desvio Exame RadiográficoAvaliar lesões Profilaxia3 semanas antes da radioterapia Tratamento PeriodontalAntibiótico Tratamento EndodônticoInterconsulta média Tratamento RestauradorAntes ou após o tratamento Exodontias e Cirurgias22 dias antes da radioterapia Table 1. Preventive Measures NeedTreatmentmento ProsthesisOpening assess painização Mouth openingAssess Injuries, dor, desvio Radiographic ExaminationAvaliar lesões Prophylaxis 3 weeks before radiotherapy da radioterapia Periodontal TreatmentAntibioticiótico Endodontic TreatmentMedical Liaisonulta média Restorative Treatment Before or after treatmentou após o tratato Surgery and extractions22 days before radiotherapyantes da radioterapia


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