How can your dentist help you before and after head and neck cancer?

The earlier the disease is diagnosed and treated, the greater the chance of a cure.

Cancer is on track to be the most common disease of the 21st century, with head and neck cancer accounting for 5% of all cancers diagnosed. 

Who of us has not experienced first-hand, in a family member, friend or in ourselves, the anguish that this word produces from minute 0?

When the first alarm goes off, our thoughts are always directed towards the end of the road, we become pessimistic and think of all that remains to be done.

Leaning on our family and friends, following the recommendations of professionals and re-analysing the situation alone or with help, can allow us to see a new horizon. Cancer can be cured!!!!

New technologies and in-depth knowledge of this "new disease", which goes hand in hand with habits and an increase in life expectancy, are helping us to win this battle.

Because, I guess you also know a lot of people who have beaten cancer, don't you?

Of the different types of head and neck cancer, 90% are squamous cell carcinoma, one of the most aggressive in existence. Survival at one year is 75% and 42% at 5 years and relapses are usually local, without distant metastases.

The appearance of this disease depends on many factors, with tobacco being the greatest risk factor, followed by alcohol, family history and viruses such as human papilloma or Epstein-Barr. Proper diet and lifestyle habits can significantly reduce the possibility of developing this unpleasant disease.

Although we should not be frightened by any abnormality that we detect, we should see a specialist to diagnose the cause. Normally, patients suffering from this disease do not feel pain, but different symptoms such as the appearance of lumps, wounds that take more than a month to heal, limited swallowing or reduced hearing attract their attention.

The cure of cancer is closely related to early diagnosis. This situation is made difficult when the disease is confused with other pathologies, or when a long period of time elapses between the appearance of the first symptoms and the patient's referral to the oncologist.

Treatment of this disease is usually surgical, assisted by preparatory or post-operative radiotherapy. In some cases, chemotherapy is used to increase effectiveness and prevent relapse.

Among the side effects of the treatment are skin and mucosal irritations, fungal infections, decreased saliva production, caries, taste alterations, limited opening, ulcers and sores, and even bone alterations. These side effects are closely related to the degree of aggression being pursued to eliminate the malignant cells.

Depending on the location of the cancer, swallowing or speaking discomfort may occur after treatment, reducing the patient's quality of life. To avoid and prevent this discomfort, it is important to seek advice from your doctor, nurse and/or dentist.

  1. Before treatment:
  • Schedule a visit with your dentist to address any dental problems you may have, as they are sure to worsen during cancer treatment.
  • Extend your hygienic habits of brushing and interdental cleaning with floss and/or interproximal brushes.
  • To prevent complications use supplements in gels, pastes or rinses with sodium fluoride and/or chlorhexidine.
  • Increase the frequency of your professional cleanings with your dentist or hygienist.
  1. During treatment:
  • Have weekly check-ups with your dentist.
  • Adapt your diet: bland diet, protein supplements, etc. Avoid acidic and spicy foods.
  • Treat the different side effects you experience:
    • Mucositis or irritation of the oral mucosa (most common): anaesthetic solutions, corticosteroids, antioxidants and/or cytoprotectors.
    • Fungal infections: antifungals.
    • Decreased saliva: hydration, sialogogues and sugar-free candies.
    • Decrease in opening with physiotherapy and gentle chewing exercises.
  • Avoid wearing prostheses that may be uncomfortable due to rubbing.
  • In addition, there are submandibular shields that help to delimit the area to be irradiated, separating the head from the neck.
  1. After treatment:
  • Despite having completed treatment, he maintains good hygienic habits and regular cleanings.
  • Treats any pathology that may have occurred during treatment. It is most common for caries to appear.
  • Avoid having extractions for 6-12 months after treatment and always have them performed with antibiotic prophylaxis.
  • Avoid the use of removable prostheses for 3-6 months after treatment.
  • In cases of permanent hyposalivation, which is quite common, salivary stimulants or artificial saliva are used.
  • Hyperbaric oxygen therapy can help heal bone wounds (spontaneous, extractions or implants).
  • Implant treatment is not contraindicated, although it does reduce the success rate. Wait 6-12 months before implant treatment.