OUTPATIENT DENTAL MANAGEMENT OF ONCOLOGICAL PATIENTS: A CLINICAL CASE REPORT (Atena Editora)

Abstract

Although salivary gland malignancies are widely distributed in adult patient populations, outpatient management still represents a challenge in the dental office. Thus, the objective of the present work was to report a clinical case on the therapeutic strategies used to restore the oral health of a patient with malignant neoplasia of the salivary glands. A 52-year-old female patient presented to the dental clinic, referred by the health unit for oral health assessment. During the anamnesis, the patient reported having Grade I Mucoepidermoid Carcinoma of the minor salivary gland. The patient reported continuous use of some medications and that she had already undergone 35 radiotherapy sessions. The patient was also using a nasal tube (5 months) and a percutaneous endoscopic gastrostomy tube (18 months). Regarding oral health, the patient reported difficulty brushing, sensitivity and gum bleeding. During clinical examination, it was possible to observe periodontitis as a manifestation of systemic disease, neoplastic lesions and extensively ulcerated mucosa, absence of teeth, extensive tooth destruction due to radiation and residual roots resulting from tooth fracture that occurred after the start of radiotherapy. As therapeutic strategies, guidance was provided regarding oral hygiene, use of artificial saliva and laser therapy. The protocol adopted was 2J of infrared for two sessions, 25 minutes each session. After significant improvement in mucosal inflammation, extraction of all teeth was performed. During the extraction sessions, 13 infrared laser sessions were carried out using a 4J protocol for 20 minutes each. After tooth extractions and laser therapy sessions, the patient discontinued the use of the nasal probe and endogastric tube. In conclusion, oral health guidance regarding brushing, use of mouthwash, artificial saliva, diet control associated with laser therapy demonstrated interesting results in the present clinical case report.