Forums › Laser Treatment Tips and Techniques › Soft Tissue Procedures › Chemotherapy-Induced Oral Mucositis
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lagunabbSpectatorIn the course of doing some reading on pharma research, I came across a discussion on mouth ulcers in chemo patients. I remember seeing the pictures and discussion shown by Dr. Tracey (Jetsfan) where he was able to help chemo patients. There seems to be a lack of awareness that dental lasers can help out there. I think dentists with lasers need to speak up at their respective communities to let oncologists and chemo patients know that they may be able to help.
Below is the introduction and there is a more substantive review at the link. I emailed the author to see if he was aware of potential laser treatment.
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Background: Most patients receive chemotherapy on an outpatient basis and are admitted to the hospital if they develop fever and neutropenia, obvious infection, or some other complication. Most of the data cited here are from studies performed on patients in an inpatient setting. Nevertheless, oral complications, when they arise in either the inpatient setting or the outpatient setting, are similar.Chemotherapy, either at conventional levels or at the higher-dosed regimens used in conditioning regimens (with or without total body radiation in preparation for bone marrow transplantation [BMT]), often results in erythema, atrophy, and ulceration of the oral mucosa, a condition generally referred to as oral mucositis (OM). OM leads to pain and restriction of oral intake. Ulcers may act as a site for local infection and a portal of entry for oral flora that, in some instances, may result in septicemia. Approximately one half of all patients who receive chemotherapy develop such severe OM that it becomes dose-limiting such that the patient’s cancer treatment must be modified, compromising prognosis. Durable disease remission and cure rates may be enhanced if more intensive therapies could be used without the untoward consequences of dose-limiting OM. Aside from direct morbidity, OM contributes indirectly to increased length of hospitalization and increased cost of treatment.
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Robert Gregg DDSSpectatorI had a patient on chemo. She broke out in terrible Herpetic lesions on the mouth. She came in for a lost crown or something. We spotted the lesions and asked if she would like us to help them. She consented. We lased with the Nd:YAG–dried them up.
She came back in a week for a post op. Said she just came from her oncologist. Her ocologist said that in all her years of chemo and cancer, she had never seen HSV-I lesions resolve during active chemo. It was unheard of at any time frame, let alone the one week resolution.
The oncologist asked for my information, said she wanted to talk with me. Never heard from her.
Physicians are NOT interested in what we as dentist do, no matter what the promise is for their patients. If it doesn’t appear in their peer reviewed journals or in their CE programs, it isn’t worth paying attention to–no matter if it means, well, a 100% reduction in heart value failures, as Dr Jorge Pinero found out after 750 successful pre-surgical laser gum treaments and no bacteremias or heart valve infections.
Sad but true.
Bob
ASISpectatorHi Bob & Ray,
If one thinks dentists are difficult to convince with new technologies and concepts in treatment, physicians in general are by far much more cautious and conservative in nature.
All we can do is change the ones whom we have a rapport with, and try to gently influence them one at a time.
Regards,
Andrew
lagunabbSpectatorThanks for the comments Bob and Andrew.
My email to the author asking for his opinion about the potential of dental laser treatment was intercepted by eMedicine’s email-screening staff implying it had no relevence to the article. Here are the authors of the article if you are ever interested in relating your dental laser experience to them.
Author: Sook-Bin Woo, DMD, Chief of Oral & Maxillofacial Pathology and Oral Medicine, Assistant Professor, Department of Oral Medicine and Diagnostic Sciences, Brigham and Women’s Hospital, Harvard School of Dental Medicine
Coauthor(s): Nathaniel Treister, DMD, Fellow, Department of Oral Medicine and Diagnostic Sciences, Harvard University School of Dental MedicineSook-Bin Woo, DMD, is a member of the following medical societies: American Academy of Oral Medicine, American Academy of Oral and Maxillofacial Pathology, American Dental Association, and International Association of Oral Pathologists
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