Dental rehabilitation after cancer surgery of the jaw addresses the replacement of teeth with the aim of contributing to the restoration of speech, chewing, swallowing and appearance.

Surgical resection of a tumor potentially requires the removal of a segment of the jaw and this may involve loss of part of the arch of teeth in the jaw. In the upper jaw (called the maxilla) this may result in the oral cavity being open to the sinuses in the maxilla and the nasal cavities.  There may be significant compromise of speech, chewing and swallowing. A dental prosthesis that closes the oral cavity will aid in restoring function, provide the replacement of teeth and assist with restoring appearance.

In the lower jaw (called the mandible) tumors of the jaw, tongue or mouth can invade the mandible and cause removal of a segment of the jaw as well as the corresponding arch of teeth. Surgical reconstruction of the mandible typically uses bone grafting from the hip or lower leg to rebuild the mandible. The replacement of teeth and their surrounding structures can be accomplished with a prosthesis that clasps onto the remaining teeth. The prosthesis will assist with improving speech, chewing and appearance. This type of prosthesis is removable and relies on the teeth and soft tissues for suppport. If too few teeth remain or if no teeth are present to stabilize a prosthesis, dental implants can be installed into the jaw to assist the replacement of teeth and rehabilitation.

Dental implants are titanium screws or cylinders that are placed into the jaw bone or bone graft. The bone cells of the jaw grow against the implant surface resulting in anchorage of the implant in the bone. This process is called osseointegration and typically requires approximately 3-4 months before dental rehabilitation procedures can be completed. If you have had radiation therapy the implant healing period may be extended. The dental prosthesis may be fixed to the implants with screws. This will mean that the person cannot remove the prosthesis. Alternatively, the prosthesis may be connected to the implants with attachments and can be removed for daily hygiene and maintenance. The number and position of implants, the availability of bone for installing implants, and financial considerations can influence prosthetic design. Use of dental implants may have potential to improve prosthetic success with possible improvement of speech, chewing, swallowing, and overall appearance. Individuals with tooth loss related to oral changes and to radiation therapy may also be candidates for dental rehabilitation.

It must be remembered that if cancer treatment has altered the ability of your tongue function to control food in the mouth or to do the fine movements that speech requires, the potential of the prosthesis to contribute to a successful outcome of treatment will be limited. Also, if the cancer treatment has negatively affected your swallow due to changes in the throat or lower down in the digestive tract then the dental prosthesis will not be able to improve your ability to swallow.

A consultation with a prosthodontist in an interdisciplinary team setting before surgery is important to sequence surgical and prosthetic procedures so as to plan dental rehabilitation optimally. This approach will be important to provide you with the best outcome of your oral rehabilitation.