HJAR Mar/Apr 2022

52 MAR / APR 2022 I  HEALTHCARE JOURNAL OF ARKANSAS ORAL HEALTH DIALOGUE COLUMN ORAL HEALTH LINKINGORALHEALTH directly in systemic diseases such as cardiovascular 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 pathogen- esis 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 medica- tions on oral health have been shown to have direct correlation to general health. Perhaps the most significant association is the role that oral health plays in various cancer thera- pies 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 from malignancies. 2 Oral infection and den- tal disease in these immunocompromised hosts are risk factors for patients undergoing life-saving therapies. This fact elevates the level of importance of medical-dental inte- gration for collaborative care to treat in the best interest of the patient and in a compre- hensive 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 sever- ity of the dental status, this could include a simple cleaning, one to multiple fillings, a tooth extraction or full mouth extractions. It is essential for patients undergoing che- motherapy, undergoing radiation or taking specific medications 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 be no infection occurring, which would com- promise this treatment regimen. Many times, the dentist is the first healthcare professional Oral Health Association on Illnesses Involving Cancer Therapies