Rehabilitation of surgical defects of the oral cavity is an ongoing activity that often continues throughout the patient's life. Our relationship can become the primary medical relationship that remains active (other than periodic examinations) after the initial surgery and other adjunctive treatments.

Ideally, a rehabilitation of a surgical or traumatic defect will restore original anatomy and function. It is therefore helpful if we see you before surgery to obtain records of the shape of your mouth. This allows the construction of any appliances needed at the time of surgery and also supplies a record of your individual normal, to which we can build to later. If it turns out that no devices are needed, the models can be easily discarded.

Cancer Surgery of the Upper Jaw and Palate:

Following cancer surgery of the upper jaw and palate, there are two types of structural loss that can result in functional and/or cosmetic defects. The first is a loss of teeth and/or the boney ridges. This type of loss may cause decreased lip support, a distorted smile, difficulty retaining existing dentures, and difficulty with speech or swallowing. Treatment for these defects consists of replacing the missing structures with fixed or removable devices.

The second type of defect is of the hard and/or soft palate. This can be combined with the tooth and bony ridge type defect. In this case a communication occurs between the nose and sinuses, and the mouth. Speech and swallowing are seriously affected by this defect and the treatment involves the construction of an obturator (a device that closes the defect, separating the mouth from the nose and sinuses). These devices are always removable and are most stable when anchored to remaining teeth and or implants. The greater the size of the defect, the more important anchorage becomes.

Three devices or major alterations to the device are usually required following this surgery. A surgical obturator is often placed at the time of surgery, in this way you can awake to relatively normal function. Following surgery the surgical device is altered or replaced as the tissues heal and change shape. When the defect becomes stable, a definitive obturator is constructed. The time frame is usually several months from the time of surgery. The placement of devices to correct surgical defects does not end prosthodontic therapy. Plastic, porcelain and metal do not change shape with time, the tissues of the mouth are constantly changing, requiring fine-tuning of the devices over time.

Cancer Surgery of the Lower Jaw:

Following cancer surgery of the lower jaw and tongue, there are two types of structural loss that can result in functional and/or cosmetic defects. The first is a loss of teeth and/or the bone of the mandible (lower jaw). This type of loss may cause decreased lip support, a distorted smile, deviation of the jaw, difficulty retaining existing dentures, and difficulty with speech or swallowing. Treatment for these defects consists of replacing the missing structures with fixed or removable devices, and redirecting the mandible when there is a deviation.

The second deficit comes when the surgery affects the tongue and floor of the mouth. In these cases there can be a restriction in movement of the tongue causing difficulty with speech and swallowing. By changing the contours of the palate, with a device resembling an orthodontic bite plate, the tongue can be made more efficient. The placement of the prosthetic devices to correct surgical defects does not end prosthodontic therapy. Plastic, porcelain and metal do not change shape with time, the tissues of the mouth are constantly changing, requiring fine-tuning of the devices over time.

Radiation Therapy and Chemotherapy

The timing of radiotherapy and/or chemotherapy can alter the timing of prosthodontic rehabilitation as well as the devices used. For more information on head and neck radiotherapy as it relates to your mouth, teeth, and restorative therapy, click here: Radiotherapy.