A London hospital has developed a method of safely removing teeth in cancer patients in desperate need of oral surgery.
Currently, patients taking certain cancer and osteoporosis medications are advised not to have any invasive dental treatment after they begin treatment.
These medications affect the jaw bone’s ability to heal, and when paired with surgery, significantly increases the risk of the jaw bone dying, an incurable condition known as osteonecrosis.
The condition has life-limiting implications including repeated infection, loss of teeth and difficulty eating.
Doctors generally avoid removing teeth in at-risk patients, leaving many in pain.
Teams at Guy’s and St Thomas’ have revealed a new four-step protocol to remove these teeth without causing osteonecrosis or disrupting cancer care, which research has found has a 99 per cent success rate.
It involves surgeons taking a 3D scan of a tooth to ensure there is no death of the jaw bone present, before a conversation between the patient’s oncologist and their dentist to determine whether cancer care should be paused.
Next, the tooth is removed and the dental surgeons then open the gum to polish, smooth and clean the bone socket before closing the gum again. This radical technique, known as alveoloplasty, helps to fast forward the healing process and protect the wound.
After surgery, patients are administered antibiotics to prevent infection.
Researchers studied the technique on 46 cancer and osteoporosis patients, with 124 teeth extracted for the trial.
None of the patients developed osteonecrosis after surgery.
Mr Vinod Patel, lead for dental services for cancer and the review, said: “The current guidance worldwide is to have your teeth checked before taking certain medications, and avoid having teeth out during or after treatment. Though this preventative approach is good practice, unfortunately extractions are still required in certain circumstances and may not be avoidable.
“We recognise that these medications are necessary and valuable for the conditions they treat, but we also have to be able to support patients with their life-long dental health, which is why we’ve created this protocol based on the patient need. We’re so happy that we’ve been able to demonstrate that necrosis can be limited during tooth extraction for these at-risk patients, and offer them a viable treatment option to relieve their pain.”
The findings were published in the British Dental Journal.
