role of dental specialities in onco.pptx

describes role of dental specialties in oral oncology

1. Role of Dental Specialties in Oral Oncology

2. Oral cancer is a significant public health concern worldwide, with a considerable impact on individuals and healthcare systems. It primarily affects the mouth and adjacent areas, including the lips, gingiva, buccal mocosa , tongue, cheeks, and throat. Almost 1 lakh new cases per year in India Common risk factors include tobacco use (both smoking and smokeless forms), alcohol consumption, betel nut and areca nut chewing, poor oral hygiene, and genetic predisposition. 90% related to tobacco products Treatment  Multidisciplinary Approach Includes surgery (most important), with radiotherapy and chemotherapy depending on patient related / disease related factors

3. Identifying Risk Factors and High-Risk Groups: Common risk factors include tobacco use (both smoking and smokeless forms), alcohol consumption, betel nut and areca nut chewing, poor oral hygiene, and genetic predisposition. These factors significantly increase the chances of developing oral cancer . Potentially Premalignant Lesions in Oral Cavity: One crucial aspect of early diagnosis is the detection of potentially premalignant lesions in the oral cavity. These lesions are not yet cancerous but have the potential to transform into cancer if left untreated. Such lesions often present as visible changes in the mouth, such as white or red patches, ulcers, or lumps. Recognizing and addressing these lesions at an early stage is essential to prevent their progression into oral cancer.

4. Role of Dental Specialties United in our expertise, each of our dental specialties becomes a beacon of hope for oral cancer patients. Together, we don't just treat the disease; we illuminate the path to a better quality of life, infuse purpose, and stand resolute against the rising tide of its incidence.

5. Oral Medicine, Diagnosis and Radiology Early diagnosis Identification of Potentially Premalignant / Malignant Lesions Screening tests Radiographically Diagnose the extent of disease Differential diagnosis from osteomyelitis, tubercular or fungal osteomyelitis, or other similar looking benign pathologies e.g Squamous Odontogenic Tumor, or other less aggressive salivary gland pathologies mimicking malignancies. Helps in 3D planning for future dental rehabilitation e.g. in cases of reconstruction with free bone flaps.

6. Oral & Maxillofacial Surgeon Diagnosis, obtaining tissue specimen for H/p evaluation, Definitive (or rarely palliative) surgery, rehabilitation of ablative defect and follow-up throughout life of the patient. MAJOR ROLE Managing major post-treatment complications e.g ORN, Xerostomia, trismus, oro -antral or oro -nasal communication etc.

7. Oral Pathologist Tissue staining, FNAC, Brush Biopsy, Exfoliative cytology for screening Tissue diagnosis  helps in treatment planning and prognostic idea Role of Immunohistochemistry to identify salivary gland neoplasms or sarcomas Intra-op frozen section analysis. Post-surgery specimen  thorough evaluation of resected specimen for identifying Stage of disease, h/p type, DOI, WPI, Lymphovascular invasion / PNI, surgical margins, ENE, Node positivity, tumor necrosis post neo-adjuvant therapies, etc. Identify need of adjunctive RT/ CT

8. Preventive Dentistry, Periodontists Screening and Early detection of suspicious cases Tobacco cessation (Emphasize that tobacco related deaths are preventable) Oral Hygiene Prevents superinfection, leading to slow growth of tumor Improves QOL, Improves surgery outcome Fluoride application to preserve teeth Post RT to reduce RT related dental caries, and ultimately preventing ORN

9. Prosthodontist Obvious role in rehabilitation of maxillectomy / palatal / velopharyngeal defects (Obturator) Dental rehabilitation (dental implant prosthesis) Improved chewing, diet, nutrition and thus role in prevention o malnutrition Provide good retention and stability to dentures Denture wearers with ill fitting dentures with chronic trauma have chance of developing oral cancer.

10. Conservative Dentistry & Endodontists Preserve the functioning teeth Pre-surgery and Pre-RT Post-RT Patients  Extractions may lead to ORN, so RCT/ restorative procedures highly recommended whenever feasible. In selected cases with Root stump / grossly decayed non-restorable teeth without active periapical infection , with recent h/o high dose RT Extraction seldom favorable Alternative option is to do RCT, and root feeling with good coronal and apical seal. Idea is not to restore the tooth, but prevent the extraction, as long as possible. Prevent and treat radiation induced caries

11. Orthodontist Also have some role in selective situation Constant trauma is a 2 nd most common etiology of oral cancer Identify malocclusion that is causing constant soft tissue injuries e.g. severe lingual inclined molars imping tongue frequently. Identify malocclusion that may imping the flap inset post resection during reconstruction.