Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Department of Radiotherapy, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Oral Dis. 2021 Jan;27(1):7-13. doi: 10.1111/odi.13329. Epub 2020 Jun 1.
Pretreatment dental screening aims to locate and eliminate oral foci of infection in order to eliminate local, loco-regional, or systemic complications during and after oncologic treatment. An oral focus of infection is a pathologic process in the oral cavity that does not cause major infectious problems in healthy individuals, but may lead to severe local or systemic inflammation in patients subjected to oncologic treatment. As head and neck radiotherapy patients bear a lifelong risk on oral sequelae resulting from this therapy, the effects of chemotherapy on healthy oral tissues are essentially temporary and reversible. This has a large impact on what to consider as an oral focus of infection when patients are subjected to, for example, head and neck radiotherapy for cancer or intensive chemotherapy for hematological disorders. While in patients subjected to head and neck radiotherapy oral foci of infection have to be removed before therapy that may cause problems ultimately, in patients that will receive chemotherapy such, so-called chronic, foci of infection are not in need of removal of teeth but can be treated during a remission phase. Acute foci of infection always have to be removed before or early after the onset of any oncologic treatment.
治疗前口腔筛查旨在定位和消除口腔感染病灶，以消除肿瘤治疗期间和之后的局部、局部区域或全身并发症。口腔感染病灶是口腔内的一种病理过程，在健康个体中不会引起重大感染问题，但可能导致接受肿瘤治疗的患者发生严重的局部或全身炎症。由于头颈部放疗患者终生面临因该治疗导致的口腔后遗症风险，因此化疗对健康口腔组织的影响基本上是暂时的和可逆的。这对头颈部放疗患者或接受血液系统疾病强化化疗的患者而言，对考虑哪些口腔病灶为感染病灶有重大影响。虽然对头颈部放疗患者，在治疗前必须去除可能导致问题的感染病灶，但对于将要接受化疗的患者，此类所谓的慢性感染病灶无需拔牙，但可在缓解期进行治疗。任何肿瘤治疗开始前或早期，都必须去除急性感染病灶。
