'Better quality of life': Why dentists should be on cancer care teams, per Dr. Dalal Alhajji

Maintaining oral health before, during and after cancer treatment plays a large role in overall health, according to one dental leader. 

Dalal Alhajji, DMD, is a clinical instructor in the oral and maxillofacial pathology, radiology and medicine department at the NYU College of Dentistry in New York City. 

She recently spoke with Becker's about the importance of having a dentist be a member of the cancer treatment team and the benefits of integrating dental into that process.

Editor's note: Responses were edited slightly for clarity and length.

Question: What kind of impact can cancer have on a patient's oral health?

Dr. Dalal Alhajji: In a nutshell, cancer treatment, regardless of what the diagnosis is or regardless of what kind of treatment patients undergo, have oral sequelae and complications that can occur in the mouth in the oral cavity. There are side effects that can be manifested in the mouth as a result of treatment, regardless of the cancer, not just head and neck cancer; it's really any cancer in the body that can have implications in the mouth.

Q: What are some of the biggest benefits of continuing to receive dental care and getting dental care while going through cancer treatment?

DA: I get patients almost on a daily basis that tell me, "I don't just want to survive cancer. It's one thing to survive cancer, but I want to be able to thrive afterwards." I think going to the dentist is important because we want to minimize the side effects so they're able to eat after they are done with cancer treatment, they're able to communicate, they're able to just live life fully similar to what they had before they even had cancer treatment. I've seen situations where patients can't open their mouth even though they're cancer free, and that's just not a way to live life, which is why I urge patients to go to the dentist very frequently. 

Q: What do you think you and other dentists can do to close the gap between receiving other medical care and receiving dental care while a patient is going through cancer treatment?

DA: On a small scale, I'm directly talking to the oncologists at NYU. I'm directly going to them, talking to them, giving them presentations, letting them know what I bring to the table as a dentist and why it's important to have a dentist be part of the cancer care team. On a much larger scale, I think it should be mandatory almost, and it's not. As I started to build this practice within NYU, I see what I refer to as "after the fact" cases — patients who are at a point of no return, had cancer, had cancer treatment and now have developed side effects that are irreversible because no one was there to intervene, monitor and help these patients out. They come to me and I'm at sort of a roadblock. I just don't want to see that in the profession, and it's very disheartening because I want patients to be able to say, "That was history, I can now live." But for those patients that are experiencing those catastrophes that could have been preventable, they are reminded on every single day that they have to go through this adversity because they are still suffering, even if they are cancer free.

Q: How do you convince doctors to add a dentist to the cancer care team?

DA: I try to convince them that I can help minimize interruptions during cancer treatment. If a patient has a tooth that has potential to flare up during the course of treatment, I want to be able to take care of that before they start. If it flares up during the process, they may have to put their cancer treatment on hold and if they do that, then that would cause more damage than ever beginning cancer treatment to begin with. I want to be able to streamline the process, be able to help out the oncology team, and I think every cancer institution should have a system in place to support that. 

Q: What are the benefits of integrated medical and dental care?

DA: Better quality of life for everyone involved. It's not just cancer, it's any disability. I think the ultimate theme of wanting to have patients thrive after cancer treatment and not just survive is really the take home message I want to hone in on.  

Q: Do you see this trend of having a dentist on a cancer treatment team gaining momentum, and do you think that it could become common practice in the future?

DA: I think one way to help encourage dentists to participate is to make it mandatory. I think that it is gaining momentum for sure, and it just takes one person. There is always someone who knows somebody who knows something. This is just the beginning of creating a team who are willing to help patients with disabilities. It's oftentimes hard to convince someone who has just been diagnosed with cancer to see a dentist because they're thinking, "Oh my god, I need to save my life, I don't have time to go to the dentist." I tell the oncologists and my patients alike, by going to the dentist, you can potentially be putting out another emergency.

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