Chemotherapy: dental considerations

For the medical management of patients receiving palliative care, see the Palliative Care Guidelines.

Ideally, patients should be dentally fit before starting chemotherapy, particularly if the chemotherapy used can cause severe mucositis and reduced salivary flow.

Some types of chemotherapy cause immune suppression, and increase the risk of oral infections such as oral candidiasis, herpes simplex virus infection and postoperative infection.

Develop dental treatment plans in consultation with the patient’s treating specialist or multidisciplinary team. Some types of chemotherapy cause significant neutropenia and thrombocytopenia, particularly with treatments for leukaemia and lymphoma. Patients with neutropenia or thrombocytopenia require specialist management for dental treatment. Perform dental procedures when the neutrophil and platelet counts are adequate; seek expert advice for emergency dental procedures. For further information on the dental management of patients with immune compromise, see here.

Tooth extraction sockets heal well in most patients undergoing chemotherapy. However, patients taking antiresorptive or antiangiogenic drugs are at risk of medication-related osteonecrosis of the jaw—seek specialist advice.