Maintaining Dental Health

Osteonecrosis (pronounced OSS-tee-oh-ne-KRO-sis) of the jaw is an uncommon condition that may involve the loss, or breakdown, of the jaw bone. It can be a serious condition. Symptoms include, but are not limited to:

• Pain, swelling, or infection of the gums
• Loosening of teeth
• Poor healing of the gums
• Numbness or the feeling of heaviness in the jaw

If you experience any of these or other dental symptoms, tell both your oncologist and your dentist immediately and follow your oncologist's recommendations regarding continuation of your cancer treatment. Your oncologist may refer you to an oral surgeon or dental oncologist with experience in osteonecrosis.

To diagnose osteonecrosis of the jaw, doctors may use X rays or tests for infection (microbial cultures). Treatments for osteonecrosis of the jaw may include antibiotics, oral rinses, and removable mouth appliances. Minor dental work may be necessary to remove injured tissue and reduce sharp edges of the bone. Surgery is typically avoided because it may make the condition worse.

Scientists do not know exactly what causes osteonecrosis of the jaw or how often it occurs. This disease has occurred in some cancer patients receiving bisphosphonates. However, a causal relationship between bisphosphonates and osteonecrosis of the jaw has not been established. Some possible factors that may increase the risk of osteonecrosis include:

• Radiation therapy to the head or neck
• Chemotherapy
• Steroid therapy (for example, cortisone)
• Underlying cancer
• Anemia (low blood count) and other bloodrelated disorders
• Infection
• A history of poor dental health
• Gum disease or dental surgery (such as pulled teeth)
• Alcohol abuse or cigarette smoking
• Poor nutrition
• Poor blood circulation or clotting problems

Once your cancer treatment has started, if you experience pain in your mouth, teeth, or jaw- or any other symptom of possible dental problems- tell both your oncologist and dentist immediately.

Dental care is an important element of your overall cancer care. Beginning as soon as possible after your cancer diagnosis, your treatment team should involve your regular dentist or a dental oncologist (a dentist who is specially trained to treat people with cancer).

• Be sure to tell your regular dentist that you are being treated for cancer
• Update your medical history record with your dentist to include your cancer diagnosis and treatments
• Provide your dentist and your oncologist with each other's name and telephone number for consultation

Print form to record information to give to your dentist and oncologist.

This document is for informational purposes and is not intended as a substitute for medical professional help or advice, nor is it intended as a recommendation for any particular treatment plan. A medical professional should always be consulted for any health problem or medical condition.

 

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