Assessment of treatment needs and goals
Individual assessment of the need for treatment
We always perform an individual case-by-case assessment of the need for treatment based on all available information and the patient’s wishes.
At the first assessment visit, we discuss not only the patient’s underlying condition, but also their basic information and medical and family history. A thorough review of all medications is essential to avoid the use of any unnecessary medicines and subsequent side effects. This is done to prevent dry mouth, a very common side effect impairing quality of life, particularly in patients with several concurrent medications.
We always perform a complete x-ray examination of the jaw area and teeth so that any asymptomatic infections that might cause serious problems can be discovered early. X- raying individual teeth may be justified, particularly if the patient has previously undergone root canal treatment. If specifically warranted, 3D imaging may be performed to provide information complementary to the x-ray.
Lymph nodes of the neck and salivary glands are examined by touch as part of the basic examination to help diagnose any potential infections or other diseases. Measuring saliva production and inflammatory markers in the saliva, combined with an examination of the teeth and oral connective tissue, provides individual-specific information to help prevent oral health problems and for basic dental care. Where necessary, we perform microbiological and blood tests to complement the clinical examination to assess infection risk and the appropriate treatment timing.
We provide all our patients with individually tailored self-care instructions complying with national and international treatment guidelines to minimise mucosal and dental damage during and after cancer therapy and to maintain their quality of life.
How we provide care
In all our activities and considering the patient’s individual situation, we follow The Finnish Medical Society’s Current Care Guidelines as well as The Multinational Association for Supportive Care in Cancer / The International Society of Oral Oncology guidelines, which we have also contributed to as consultants.
We represent conventional Western medicine but based on our experience we may also recommend safe non-medicinal products for individual needs such as the self-care of dry mouth. Our aim is always to find the most suitable treatment and products for each patient based on their individual needs.
If left untreated, dental infections and diseases of the oral mucous membrane act as a gateway for infections to the entire body. The prevention of localised and generalised complications from infections is our main goal, and the patient’s teeth and chewing ability should be preserved wherever possible. Most dental infections can be overcome with timely preserving treatment. The goal is to prevent and treat infections effectively with procedures that are as minimally invasive as possible.
However, teeth with a poor prognosis that contribute to oral infection may have to be extracted if necessary for treatment of the cancer. In such cases, too, we strive to accelerate wound healing as much as possible by using tissue-preserving operative techniques, which also provide a good starting point for the subsequent restoration of chewing ability carried out with implants.
Another major goal in our oral care is a pain-free mouth, which is essential for both oral nutrition and social life. Neither of these should be underestimated at any stage of the illness. Pain management is an essential part of both curative and palliative care, the latter of which may be a surprisingly long and valuable life period both for the patient and for their loved ones.
Any necessary dental procedures are performed painlessly under carefully administered local anaesthesia. When needed, we also administer medicines to alleviate anxiety and fear or use sedation. General anaesthesia is usually not needed for dental care but if requested by the patient can be performed by an anaesthesiologist.