Annual Report 2022
Department of Dentistry
Tetsuhito Konishi, Terumi Takeuchi, Tomoko Kanata, Reiko Kishi, Yurika Mizutani
Introduction
We are working to address the diverse intraoral complications associated with cancer treatment and to maintain and improve the patients’ quality of life (QOL) in the field of dentistry.
Cancer treatment is frequently associated with a variety of intraoral complications, such as mucositis, taste disorders, dry mouth, pain, and infections. Patients undergoing treatment for head and neck cancer (chemoradiotherapy, surgery) and hematopoietic stem cell transplantation are particularly susceptible to severe intraoral symptoms, necessitating stringent infection control measures.
When such measures are inadequate, composite complications may result in secondary complications such as eating disorders and undernutrition, with the oral cavity potentially becoming a source of systemic infections. These can lead to the need to postpone or discontinue treatment, making continuation and completion of cancer treatment difficult.
We evaluate and stabilize the oral status before the initiation of cancer treatment to manage and prevent intraoral complications. Proactive intervention by dentists or dental hygienists to educate the patients, their families, and the attending medical staff is extremely important.
The Team and What We Do
Our efforts encompass preventing wound infections and aspiration pneumonia and to reducing other complications through oral hygiene management before and after surgery. To maintain postoperative function of jaw defects, we are working to correct speech-language and eating functions by preparing appropriate artificial dentition and prostheses at an early stage, thereby improving the QOL of patients after treatment. For patients receiving chemotherapy and radiotherapy, we support continuation and completion of treatment by taking measures to prevent infections arising from the dentistry realm and mucositis and by reducing pain. In regard to delayed complications, we undertake preventive and treatment measures for multiple dental caries, osteomyelitis of the jaw, and necrosis of the jaw bone. Patients treated over the long-term with zoledronic acid or denosumab can develop medication-related osteonecrosis of the jaw (MRONJ) due to contamination of the oral cavity and tooth extraction; thus, we take measures to prevent/treat this complication.
By participating in multidisciplinary conferences, we apply prevailing practices and information updates to future medical care support.
In 2022, the numbers of new and revisiting patients were 1,342 and 10,870 respectively, and the total number of patients was 12,212. We believe that the importance of supportive care in cancer has gained recognition.
Research Activities
We are participating in a multicenter study conducted to evaluate the effectiveness of proactive use of supportive care for preventing severe oral mucositis in patients with head and neck cancer undergoing chemoradiotherapy.
We are performing a study on multiple dental caries and radiation-induced osteomyelitis developing after radiotherapy for head and neck cancers. In addition, we are a part of the nutrition support team.
We cooperate with other facilities to establish oral care programs for patients with head and neck cancers receiving chemoradiotherapy.