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By Kalu U E Ogbureke

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To eliminate oral infections and avoid tooth originated systemic ones. to prevent, eliminate or control oropharyngeal pain. to prevent or control salivary gland dysfunctions and tooth destruction. to prevent or reduce the incidence of bone necrosis. The first step of the treatment should be a panoramic X-Ray in order to have a global vision. If tooth extractions are necessary for non-restorable or doubtful prognosis teeth (see criteria in Table 7), they should be made 15-20 days before radiation treatment and 5-10 days before chemotherapy.

6. Risk factors and location of the tumor To highlight: It is essential for everyone to undergo a proper oral examination. Pain in itself is not a reliable indicator of malignancy; in many of the studied cases, early lesions were associated with only minor discomfort. 1 Lymph nodes According to the natural history of OSCCs, invasive lesions would lead to their spreading through the lymph nodes. Mobile, painless nodes whose volumes increase in course of time, and fix to surrounding tissue in the advanced stages, are those clinically suggestive of malignancy.

1997). Candidiasis can cause a burning or scalding sensation, can distort taste and may interfere with swallowing. Its spread to the esophagus or systemic dissemination is a serious consequence (Rankin & Jones, 1999). Other opportunistic fungal infection is Histoplasmosis. Bacterial and viral infections are more common in neutropenic patients than in those affected by oral cancers. The detection and treatment of those infections represent a challenge to health professionals and should be the subject of a more extensive study.

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