1. Management of oral cancer
Treatment of Malignancy.
Early diagnosis is the most important factor in successful treatment.
Clinical diagnosis
Chronic ulcer or fissure with no apparent cause and do not respond to treatment.
Swelling with dilated small vessels over the surface and no oedema or redness.

2. Management of oral cancer Clinical diagnosis
Rapid loosening of group of teeth, irregular bony destruction, deep periodontal pocket in good healthy mouth or due to minimal trauma.
Signs of infiltration as tethering of an organ or L.O.M.
persistent pain, anaesthesia or paraesthesia.
Signs of obstruction of ducts or veins engorgement.

3. Management of Oral Cancer Clinical diagnosis
Repeated small haemorrhage with no obvious cause.
signs of involvement of muscles.
Enlarged lymph nodes with no oedema or obvious cause.
Abscesses without a cause.
Malaise, sweating and toxicity without infection.

4. Management of oral cancer
The treatment involves:
investigations.
Documentation.
This may includes examination under general anaesthesia, special procedure e.g. CT‑scan, MRI, biopsies, etc.
One or a combination of:
Radiotherapy.
Surgery.
Chemotherapy.

5. Management of oral cancer
The choice of therapy depend on many variables.
The site of the lesion.
The stage of the disease.
The age and the medical status of the patient.
An important factor is to ensure that the cure is better than the disease, i.e. the quality of life.

6. Management of oral cancer
Surgery
have a major part in all cancer patients and mainly small primary lesions without obvious lymph node involvement.
Radiotherapy
the sole modality for large inoperable tumors.
Most patients receive a combination of radiotherapy and surgery.
Chemotherapy
is of limited value in oral cancer although the search for an effective agent still continues.

7. Management of Oral Cancer
Complication: .
Complication of dental treatment after radiotherapy is very serious and it might be necessary to plan treatment prior to institute the irradiation.
Extraction.
may lead to necrosis of bone, osteoradionecrosis.
Radiation induced endarterities lead to reduced bone vascularity and extraction will lead to intractable osteomyelitis.

8. Management of Oral Cancer
Mucositis:
Mucosal erythema followed by sloughing with pain,dysphagia and soreness 2 ‑ 4 weeks after radiotherapy.
This will clear in 2 ‑ 3 weeks.
The use of antibiotics to clear mouth of Gram-negative bacteria might minimize the condition.
Normal saline mouthwashes.

9. Management of Oral Cancer
Xerostomia:
Suppression of salivary secretion and the increase in viscosity is due to damage to salivary glands.
Libral use of artificial saliva is usually the best and the condition may remain an intractable problem.

10. Management of Oral Cancer
Loss of taste:
Xerostomia and radiation damage taste buds causes hypogeusia.
Recovery is within 2‑4 months unless higher dose was used then the loss is permanent.

11. Management of Oral Cancer
Radiation caries and hypersensitivity:
Salivary changes predispose to caries.
Damage to teeth ,changes in diet may predispose to rampant dental caries which might involves any site.
Diet control, daily topical fluoride applications in the form of mouth washes or gel are used.

12. Management of Oral Cancer
Denture:
Mucosal trauma from denture may predispose to osteomyelitis.
They should not be fitted before six months after radiation.

13. Management of Oral Cancer
Trismus:
Endarteritis and subsequent replacement fibrosis in the masticatory muscles 3 ‑ 4 months.
Instituting jaw‑opening exercises with tongue spatulas will reduce trismus.