HJAR Nov/Dec 2020

44 NOV / DEC 2020 I  HEALTHCARE JOURNAL OF ARKANSAS ORAL HEALTH DIALOGUE COLUMN ORAL HEALTH IN THIS SERIES of articles, we’ve discussed the many ways oral health is connected to the body’s various systems. Linking oral health directly in systemic diseases such as cardio- vascular disease and diabetes has science- based evidence that there is a bi-directional link. 1 Acknowledging that infections in the oral cavity, especially periodontitis, affect the course of pathogenesis in heart disease, bacterial pneumonia, diabetes mellitus, and low birth weight has been well documented. 2 Also, aging dentitions in older populations and effects of medications on oral health have been shown to have direct correlation to general health. Perhaps the most signifi- cant association is the role that oral health plays in various cancer therapies associated in combating these illnesses. The oral cavity functions as a site of origin for distribution of pathogenic bacteria, which disperse to outlying body sites, particularly in medically compromised patients who suffer frommalignancies. 2 Oral infection and dental disease in these immunocompromised hosts are risk factors for patients undergoing life- saving therapies. This fact elevates the level of importance of medical-dental integration for collaborative care to treat in the best in- terest of the patient and in a comprehensive manner. 3 Cancer therapies involve a combination of options including chemotherapy, radia- tion and surgeries. The patient is pressed to make decisions for choosing the best course of action with their doctors, resulting in life- or-death outcomes. 4 This serious scenario often involves the necessity to rid the mouth of infection or disease. Suddenly, the patient must also seek dental treatment if they have poor oral health. Depending on the severity of the dental status, this could include a simple cleaning, one to multiple fillings, a tooth ex- traction or full mouth extractions. It is essen- tial for patients undergoing chemotherapy, undergoing radiation or taking specific medi- cations for cancer therapy to obtain dental clearance. Dental clearance is documentation by the patient’s dentist that his/her oral health has no infection or disease present. This is re- quired before chemotherapy or radiation, as well as before certain surgeries or before taking specific medications for cancer treat- ment. 5 This written attestation states that the patient’s oral status is void of dental disease and confirms there is no infection or disease present. Poor oral health compromises treat- ment therapies. This formal, written declara- tion is often accompanied with a clear direc- tive to the patient that he/she must maintain proper oral hygiene with due diligence. For example, in preparation of receiving chemotherapy, radiation and bone marrow transplant to treat acute leukemia types, den- tal clearance is required. Ahealthy dentition is essential due to the necessity that there Oral Health Association on Illnesses Involving Cancer Therapies