Oral Oncology and Oral Medicine Fellowship for the General Dentist ^†

1. Aim or Purpose

Cancer patients and survivors are increasing [1] and may present with unique oral health needs. The majority of dentists do not have adequate education [2], training and experience [3] in the management of toxicities secondary to cancer therapy [4]. As such, we implemented a new oral oncology and oral medicine fellowship to meet these needs. The goal of this study was to determine the number of cancer patient visits, patient demographic information, and diagnoses in a single center training program.

2. Materials and Methods

A retrospective electronic medical record review was conducted from October 2018 till January 2019 for all patients seen by the fellow while rotating through the medical oncology departments at Dana Farber Cancer Institute. Patients were evaluated by the medical oncologist and the fellow at each visit. Data were tabulated into an electronic spreadsheet and descriptive statistics were used.

3. Results

586 patients (349 females, 59.6%) with a median age of 62 (range: 25-88) were seen. Of all patients seen, 402 (68.6%) had cancer. The most common cancer diagnoses included hematologic (179; 44.5%), head and neck (77; 18.6%), breast (73; 18.1%), thoracic (22; 5.5%) and bone malignancies (17; 4.2%).Oral complications were present in 96 (23.8%) patients and included dry mouth (60; 14.9%), ulcers (49; 12.2%), and chronic GHVD (25; 6.2%).Over the year, 122 procedures were performed (which 67.2% represented surgical extractions and biopsies) and 196 prescriptions for medications were done. Patients affected by head and neck cancer (35/77; 45.4%) and hematologic malignancies (55/179; 30.7%) had the highest risk of presenting with oral toxicities.

4. Conclusions

Oral complications from cancer therapy are common and may require a multidisciplinary approach. Adequately trained dentists are a valuable resource for the community to provide safe and effective oral care for oncology patients.