{"id":3527,"date":"2024-04-29T12:30:00","date_gmt":"2024-04-29T10:30:00","guid":{"rendered":"https:\/\/www.dentalespace.com\/patient\/?p=3527"},"modified":"2024-04-24T09:37:31","modified_gmt":"2024-04-24T07:37:31","slug":"chimiotherapie-radiotherapie-attention-dents","status":"publish","type":"post","link":"https:\/\/www.dentalespace.com\/patient\/chimiotherapie-radiotherapie-attention-dents\/","title":{"rendered":"Chimioth\u00e9rapie et radioth\u00e9rapie, attention \u00e0 vos dents !"},"content":{"rendered":"\n

Bien qu’on ne le soup\u00e7onne pas, les traitements anticanc\u00e9reux affectent la bouche<\/strong> et ses diff\u00e9rents composants.<\/p>\n\n\n\n

<\/p>\n\n\n\n

La chimioth\u00e9rapie<\/mark><\/h2>\n\n\n\n

N\u00e9e dans les ann\u00e9es 1940, la chimioth\u00e9rapie est un traitement chimique qui d\u00e9truit les cellules canc\u00e9reuses<\/strong> en s’attaquant \u00e0 des mol\u00e9cules sp\u00e9cifiques, responsables de la croissance des colonies de cellules canc\u00e9reuses.
Elle s’administre de fa\u00e7on pr\u00e9ventive, pour pr\u00e9venir l’infection et ses cons\u00e9quences, ou curative, pour baisser l’\u00e9tat d’avancement du cancer.<\/p>\n\n\n\n

Ce traitement s’administre de diff\u00e9rentes mani\u00e8res :
\u2022 par voie orale<\/strong> (prise d’un m\u00e9dicament),
\u2022 par intraveineuse<\/strong> (pose d’un cath\u00e9ter dans les veines),
\u2022 par chambre sous-dermique<\/strong> (pose d’un petit bo\u00eetier et d’un cath\u00e9ter sous la peau, plac\u00e9 au niveau du thorax).<\/p>\n\n\n\n

<\/p>\n\n\n\n

\"chimioth\u00e9rapie\"<\/figure>\n\n\n\n

<\/h3>\n\n\n\n

La chimioth\u00e9rapie est un bulldozer qui touche de fa\u00e7on efficace les mauvaises cellules. Bien que son effet soit heureusement limit\u00e9 aupr\u00e8s des cellules saines, le traitement perturbe aussi leur multiplication, avec des cons\u00e9quences bucco-dentaires<\/strong>.<\/p>\n\n\n\n

On observe notamment :
\u2022 Des douleurs au niveau des dents ou des gencives<\/strong>.
\u2022 Une diminution de la salivation, ce qui engendre une s\u00e9cheresse buccale<\/strong>. Au quotidien, les effets sont directs : difficult\u00e9 \u00e0 avaler sa salive ; alt\u00e9ration de l’\u00e9tat de surface de l’\u00e9mail, qui devient plus transparent. Moins bien prot\u00e9g\u00e9es, vos dents s’exposent ainsi \u00e0 un plus grand risque carieux.
\u2022 Des plaies au niveau des muqueuses<\/strong> (langue, joues) ainsi que des l\u00e9sions aux gencives (ulc\u00e8res, aphtes…).
\u2022 Une limitation des mouvements articulaires de la m\u00e2choire<\/strong> qui donne une impression de paralysie<\/strong>. Parler, m\u00e2cher ou bailler devient inconfortable. Ce d\u00e9sagr\u00e9ment dispara\u00eetra apr\u00e8s le traitement.
\u2022 Des vomissements<\/strong> dont l’acidit\u00e9 provenant de l’estomac, peut rendre poreuse la surface de vos dents. Pensez \u00e0 bien rincer votre bouche \u00e0 l’eau claire \u00e0 chaque occasion.
\u2022 Une alt\u00e9ration du go\u00fbt<\/strong>, avec une sensation m\u00e9tallique dans la bouche.<\/p>\n\n\n\n

Les bisphosphonates<\/mark><\/h3>\n\n\n\n

Le traitement par bisphosphonates, qui est une forme de chimioth\u00e9rapie, ralentit la r\u00e9sorption osseuse. Ces mol\u00e9cules sont, aujourd’hui, souvent administr\u00e9es aux femmes touch\u00e9es par l’ost\u00e9oporose, notamment apr\u00e8s la m\u00e9nopause.<\/p>\n\n\n\n

<\/p>\n\n\n\n

\"biophosphonates\"<\/figure>\n\n\n\n

<\/p>\n\n\n\n

Ces mol\u00e9cules att\u00e9nuent la douleur caus\u00e9e par les cancers osseux, r\u00e9duisent le risque de fracture, mais peuvent provoquer une ulc\u00e9ration osseuse grave, l’ost\u00e9on\u00e9crose, par perte des facult\u00e9s de r\u00e9paration et de cicatrisation.<\/p>\n\n\n\n

<\/p>\n\n\n\n

Certains traitements dentaires chirurgicaux comme les extractions, les \u00e9longations coronaires (abaissement de la gencive pour fair ressortir la racine), les d\u00e9tartrages profonds deviennent alors contre-indiqu\u00e9s <\/strong>ou r\u00e9alisables dans des conditions d’asepsie et d’antibioth\u00e9rapie lourdes, en milieu hospitalier.<\/p>\n\n\n\n

<\/p>\n\n\n\n

La radioth\u00e9rapie<\/mark><\/h2>\n\n\n\n

Les pr\u00e9mices de la radioth\u00e9rapie date de la fin du 19\u00e8<\/sup> si\u00e8cle. Gr\u00e2ce \u00e0 un rayonnement ionisant tr\u00e8s cibl\u00e9, elle d\u00e9truit les cellules canc\u00e9reuses en les emp\u00eachant de se multiplier.<\/p>\n\n\n\n

<\/p>\n\n\n\n

\"radioth\u00e9rapie\"<\/figure>\n\n\n\n

<\/h3>\n\n\n\n

La radioth\u00e9rapie pr\u00e9sente tout de m\u00eame diff\u00e9rents effets n\u00e9fastes sur votre sourire et votre sant\u00e9 bucco-dentaire.<\/p>\n\n\n\n

Dans le champs d’irradiation, le traitement va :
\u2022 St\u00e9riliser les glandes salivaires. La bouche devient s\u00e8che<\/strong>. L\u00e0 aussi, la salive n’assure plus son r\u00f4le de protection et de lubrification.
\u2022 Provoquer des plaies sur les muqueuses
\u2022 Limiter l’ouverture de l’articulation prise dans le champ d’irradiation.
\u2022 Br\u00fbler les petits vaisseaux sanguins<\/strong> des muqueuses et de l’os, qui perdent leur facult\u00e9 de cicatrisation.<\/p>\n\n\n\n

<\/p>\n\n\n\n

Les conduites \u00e0 tenir<\/mark><\/h2>\n\n\n\n

Avant le traitement :<\/strong>
Faire r\u00e9aliser un contr\u00f4le pouss\u00e9 par son chirurgien-dentiste et les soins n\u00e9cessaires<\/strong> (d\u00e9tartrage, caries, extractions), pour \u00e9viter urgence et infection pendant le traitement. Une dent litigieuse ne peut pas \u00eatre conserv\u00e9e sauf \u00e0 prendre un risque futur.<\/p>\n\n\n\n

<\/p>\n\n\n\n

\"contr\u00f4le<\/figure>\n\n\n\n

<\/p>\n\n\n\n

Pendant le traitement :
<\/strong>La surveillance doit \u00eatre r\u00e9guli\u00e8re, l’hygi\u00e8ne extr\u00eamement rigoureuse<\/strong>, l’alimentation adapt\u00e9e, notamment par une franche r\u00e9duction des sucres rapides dont se nourrissent les cellules canc\u00e9reuses (1)<\/sup>.
Si la salive naturelle vient \u00e0 manquer, rendez-vous en pharmacie. Des gels ou des sprays adapt\u00e9s apportent un confort dans le quotidien.
On supprimera le tabac et l’alcool<\/strong>, dont la consommation conjointe est \u00e0 l’origine de cancers de la muqueuse buccale.<\/p>\n\n\n\n

Si une extraction devait \u00eatre n\u00e9cessaire, un protocole sp\u00e9cifique en milieu hospitalier est requis pour \u00e9viter l’ost\u00e9on\u00e9crose.
Les risques sont faibles voire inexistants pour les soins courants (d\u00e9tartrage, soins de caries…)<\/p>\n\n\n\n

<\/p>\n\n\n\n

Apr\u00e8s le traitement :
<\/strong>Des solides et saines habitudes hygi\u00e9no-di\u00e9t\u00e9tiques<\/strong> doivent d\u00e9sormais faire partie du quotidien, avec deux objectifs : faire chuter le risque de rencontrer des probl\u00e8mes et aider l’organisme \u00e0 se refaire une sant\u00e9.<\/p>\n\n\n\n

<\/p>\n\n\n\n

Les dents peuvent-\u00eatre prot\u00e9g\u00e9es par une goutti\u00e8re de fluoration<\/strong> pour limiter le risque carieux.
Les vernis fluor\u00e9s, utilis\u00e9s dans la bouche des enfants, n’ont pas fait leurs preuves chez les patients irradi\u00e9s et pr\u00e9sentent m\u00eame des contre-indications en cas d’inflammation des muqueuses ou d’ulc\u00e9rations (2)<\/sup>.<\/p>\n\n\n\n

<\/p>\n\n\n\n

\n\n\n\n

<\/p>\n\n\n\n

Cet article vous est propos\u00e9 par le Dr Fran\u00e7ois Thibault.
D\u00e9couvrez le dernier article du praticien sur le blanchiment dentaire<\/strong><\/a> !<\/p>\n\n\n\n

\"Dr<\/figure>
\n

Dr Fran\u00e7ois Thibault, chirurgien-dentiste, consultant en pr\u00e9vention bucco-dentaire et cr\u00e9ateur du site www.preventissimo.fr<\/a>.<\/strong>
\u00ab J’informe, je vulgarise, je sensibilise, je forme \u00e0 la sant\u00e9 et au bien-\u00eatre bucco-dentaire. Pour une pr\u00e9vention efficace et choisie ! \u00bb<\/p>\n<\/div><\/div>\n\n\n\n

<\/p>\n\n\n\n

R\u00e9f\u00e9rences bibliographiques<\/mark><\/h3>\n\n\n\n

(1) C. <\/strong>Debras, et al<\/strong> – Total and added sugar intakes, sugar types, and cancer risk: results from the prospective NutriNet-Sant\u00e9 cohort; American Journal od Clinical Nutrition<\/em> – 16 septembre 2020<\/p>\n\n\n\n

(2) C. Cardot<\/strong> – Effets de la radioth\u00e9rapie sur les structures dentaires : utilisation de deux vernis fluor\u00e9s: \u00e9tude exp\u00e9rimentale. Sciences du Vivant [q-bio]<\/em> – 2019.<\/p>\n","protected":false},"excerpt":{"rendered":"

Bien qu’on ne le soup\u00e7onne pas, les traitements anticanc\u00e9reux affectent la bouche et ses diff\u00e9rents composants.<\/p>\n","protected":false},"author":1,"featured_media":3536,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"_et_pb_use_builder":"off","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"categories":[13],"tags":[227,231,228,229,230,226,234,225,199,223,224,232,233],"class_list":["post-3527","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-radiologie","tag-cancer","tag-cancerigene","tag-cancers","tag-cellule-cancereuse","tag-cellules-cancereuses","tag-chimio","tag-chimio-dent","tag-chimiotherapie","tag-dent","tag-radio","tag-radiotherapie","tag-tumeur","tag-tumeurs","et-has-post-format-content","et_post_format-et-post-format-standard"],"yoast_head":"\nChimioth\u00e9rapie 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