Prosthodontic rehabilitation of patients with orofacial defects

In 2007, in the UK 5410 people were diagnosed with an oral cancer.1 This is an important statistic since it indicates that those who examine the mouth regularly may encounter tumours. Early diagnosis is therefore of great importance in relation to the management of patients with these lesions. It is imperative that all dentists, medical practitioners and dental care practitioners are vigilant when examining the oral cavity so that any suspicious ulcers, swellings or changes in colour of the mucosa are referred at the earliest stage.

Tumours that occur in the upper jaw include:

Tumours that occur in the lower jaw include:

Figure 1 shows an example of an adenoid cystic carcinoma in the palate.

To give the patient the best prognosis with an orofacial tumour it is most important to have the correct skills in a multidisciplinary team. This should include the general dental practitioner, who may well be the first to have diagnosed the tumour, an oral and maxillofacial surgeon, an oncologist and an ENT surgeon or plastic surgeon, whose role it will be to plan the surgery. The responsibility for restoration lies with the prosthodontic or restorative specialist who has been trained to care for patients with such disability, along with a maxillofacial technician, dedicated dental nurse, therapist, hygienist and speech therapist. The team should also include a dietician since the patient will require specially prepared food in the post-operative phase and may require a gastric tube for a short time.