The oncological patient in dentistry: management and prevention,Il paziente oncologico in odontoiatria: gestione e prevenzione

OBJECTIVES According to the clinical recommen dations of the Ministry of Health for the promotion of oral health, the Press vention of oral pathologies and odon tostomatological therapy in adult pa tients with neoplastic disease, is im portant to give precise indications to the dentist and the dental hygienist on the correct ranges of intervention in the management of these patients. It is also essential to guarantee ade quate patient information on the pro motion of oral health, on complica tions of oncological treatments and on their possible prevention. The objec tive of this paper is to give the clinician the necessary information in order to know how to correctly manage onco logical patients with head and neck cancers, oncological patients under going chemotherapy, patients undergoing hematopoietic stem cell trans plantation. For all the categories de scribed is important to know the cor rect timing in which dental profession als can perform the necessary treat ments safely. MATERIALS AND METHODS In this narrative review of the litera ture, for each category of patient de scribed above, the clinician is given the necessary indications for the cor rect management of the patient be fore, during and after the beginning of oncological therapies. The possible side effects caused by the therapies are then analyzed in detail and, for each complication, indications are given on the related management. The dentist and the dental hygienist have also an active role in the screening of oral cancer. To prepare this form, a search of recent scientif ic literature was carried out by con sulting the databases of PubMed, Cochrane and the current Ministerial Guidelines. RESULTS AND CONCLUSIONS The prevention and odontostomato logical management of the oncologi cal patient are an integral part of the clinical care path to which the patient is subjected. It is important to evalu ate the possibility of taking care of these patients in the office or the need to refer them to hospital, de pending on the clinical case and on the systemic condition. The data re ported in literature highlight how central an adequate management of oral complications related to onco logical therapies is for the quality of life of patients. In recent years, the dental team has found itselfhaving to treat and man age many cancer patients with com plex clinical cases. It is therefore es sential for all professionals involved to be adequately trained inthe most suitable procedures in order to have a correct preventive and therapeuticapproach in the management of on cological patients. Dental profession als must beintegrated into the multi disciplinary management of this deli cate category of patients.