ABSTRACT
The current management of the majority of head and neck cancers has evolved over the past several decades into a multidisciplinary specialty, with participation by head and neck surgeons, radiation oncologists, medical oncologists, maxillofacial surgeons, reconstructive surgeons, dentists and prosthodontists, rehabilitation specialists and supporting services. The goal of the multidisciplinary team is to maximize tumor control and minimize treatment-related sequelae, which impact upon the quality of life. Nowhere in the head and neck region is this more important than in the oral cavity and the oropharynx. The role of the dental surgeon and the prosthodontist is crucial from the day of initial diagnosis until after completion of treatment, rehabilitation and, thereafter, lifelong for management of the long-term sequela and complications of treatment. Thus, the involvement of the dental surgeon begins with pretreatment assessment of the patient's dentition, appropriate interventions and prophylactic treatments for effective and safe delivery of initial definitive treatment of the cancer. Intraoperative and perioperative dental management is crucial to the successful outcome of a surgical procedure. Similarly, pre-radiation assessment of dentition, fabrication of protective devices during radiation and post-radiation management of the radiated dentition are crucial to the successful outcome of treatment with radiation with none or minimal impact of radiation exposure on the teeth. Management of the dentition in patients receiving chemotherapy is equally important and complex. Avoidance of complications due to long-term bisphosphonate therapy is an integral part of the overall care of the patient. Finally, when reconstructive surgery has not or cannot restore a patient's appearance and function, the availability of external prosthetic devices should be considered. These personalized, individually fabricated devices significantly improve form and function and thus the quality of life after treatment of patients with head and neck cancers (1).
