title: A prospective pilot study to evaluate a new dental assessment and treatment paradigm for patients scheduled to undergo intensive chemotherapy for cancer.
abstract: BACKGROUND
  Patients scheduled to receive chemotherapy frequently undergo pretherapy dental treatment to eliminate potential sources of odontogenic infection. A prospective study was conducted to assess a new protocol emphasizing minimal pretherapy dental treatment.
  
  
  METHODS
  Forty-eight consecutive patients diagnosed with solid or hematologic neoplasms underwent dental examination prior to intensive chemotherapy. All chronic dental pathology was scored as either mild-to-moderate or severe based on the likelihood of conversion to an acute state during chemotherapy. No pretherapy dental treatment was given to patients with chronic dental disease. Intertherapy dental complications and the overall impact on chemotherapy outcomes were assessed.
  
  
  RESULTS
  Thirty-eight patients (79%) were diagnosed with pretherapy chronic dental pathology. Twenty-one of these patients (44% of the total population) were identified as having severe pathology and considered at risk for acute intertherapy dental complications. Two patients (4%) experienced acute intertherapy episodes, each presenting as oral abscesses. In both cases, resolution was achieved with antibiotics without interruption of chemotherapy. Oncologic treatment outcomes for all patients were judged to be unaffected by either the presence of chronic pretherapy dental disease or acute intertherapy exacerbations of these disease states.
  
  
  CONCLUSIONS
  These results demonstrate that patients with chronic dental pathology can safely proceed with chemotherapy without dental intervention, as conversion of chronic dental disease to an acute state during chemotherapy occurs infrequently. If intertherapy dental infections do arise, they can be managed effectively without interrupting therapy or adversely affecting oncologic treatment outcomes.
authors.affiliation: Zoller Dental Clinics, The University of Chicago, Illinois 60637, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Toljanic
authors.forename: J F
authors.initials: JF
authors.lastname: Bedard
authors.forename: R A
authors.initials: RA
authors.lastname: Larson
authors.forename: J P
authors.initials: JP
authors.lastname: Fox
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000741:Anemia, Aplastic / Q000150:complications / Q000188:drug therapy; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D019090:Case Management; D017742:Dental Care for Chronically Ill; D003731:Dental Caries / Q000150:complications; D005260:Female; D005491:Focal Infection, Dental / Q000517:prevention & control*; D005891:Gingivitis / Q000150:complications; D019337:Hematologic Neoplasms / Q000150:complications / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy*; D009503:Neutropenia / Q000139:chemically induced; D010510:Periodontal Diseases / Q000150:complications; D010865:Pilot Projects; D011446:Prospective Studies; D014081:Tooth Extraction; D016896:Treatment Outcome