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Chasing the cure: Dentists help social media influencer treat oral effects of cancer treatment

November 05, 2019

By Kimber Solana

Chasing the Cure before and after
Before and after: Dr. Marko Tadros digitally printed a custom-built temporary fixed prosthesis for Quendella Davis. Dr. Tadros will also construct the final fixed prostheses. 
Atlanta — Quendella Davis was only 13 years old when she conquered nasopharyngeal cancer after enduring 36 treatments of radiation and chemotherapy.
   
While Ms. Davis is now cancer free, the radiation therapy left her oral health in disarray.
   
Chasing the cure
New smile: From left, Dr. Abtin Shahriari, Quendella Davis and Dr. Ronald E. Goldstein pose for a photo during Quendella's first visit with the two dental specialists.

“I was 21 years old when my teeth started to decay,” Ms. Davis, 27, said in Chasing the Cure, a 24/7 digital platform program anchored by journalist Ann Curry that helps people who are suffering from undiagnosed, misdiagnosed or uncured medical mysteries connect with health care experts.

“Just seeing bits and pieces of your tooth come out, it’s always pretty petrifying,” she said in the program. For the past 5 years, Ms. Davis has suffered more than 100 mouth infections, making it nearly impossible to eat, and dentists told her there was little they could do.

“I can’t do this alone,” she said.

Today, she no longer has to. After she shared her story on the program this summer, a team of dental specialists from Goldstein, Garber & Salama, a restorative dentistry practice in Atlanta, offered to help. They conducted a comprehensive oral exam including 3D imaging in order to develop a treatment plan.  Adverse effects of radiotherapy to treat her cancer were seen to include salivary gland and jaw bone damage.  This was a genesis of the oral infections and extensive tooth decay she experienced.

“I feel like I was in a facility of angels,” Ms. Davis told ADA News about her experience with meeting Dr. Ronald E. Goldstein and his team. It was Dr. Goldstein, an ADA life member, who shocked Ms. Davis on the Chasing the Cure program when he announced that his team would help her regain her smile and improve her quality of life — at no cost to her.

A hygienist had seen Ms. Davis’ story in Chasing the Cure and contacted the program about Dr. Goldstein, Dr. Abtin Shahriari, an oral and maxillofacial surgeon who is part of the team and an ADA member, told ADA News. The program then contacted Dr. Goldstein and his team about taking on Ms. Davis’ case. They agreed.

“My experience with [Dr. Goldstein’s] whole staff was literally amazing; everyone greeted me and made me feel welcomed,” she said. “The doctors were very informed with my condition and had a game plan of giving me a smile before I left.”

This plan includes allowing the surgeons to extract the teeth that need to be removed and to keep the teeth that can be saved, Dr. Shahriari said. The first in her treatment is multiple exposures to hyperbaric oxygen, which began Oct. 21, as per the HBO protocol established by the team of dental specialists for head and neck radiated patient.

The goal is for the dental team to help build a healthy tooth structure that can support a durable fixed upper and lower prosthesis. Afterward, Ms. Davis will need to continue to maintain the health of her teeth to prevent further infection, which will include regular visits to the dentist.

“Certainly our first step is the most conservative thing that we’re doing and it’s trying to contain the infection that she has as well as improving her smile and the ability to masticate with fixed prosthesis,” Dr. Goldstein said.

After surgical extraction of the nonrestorable teeth, Ms. Davis will receive additional HBO treatment, along with additional treatment from the Augusta University Department of Endodontics.

Radiation to the head and neck region in cancer treatment can affect the cells and bones of the maxilla and mandible. Because of this, Dr. Shahriari said, it’s important for oncologists to involve an oral and maxillofacial surgeon when treating cancer patients so a team of dental specialists can create a treatment plan for the patient prior to the start the radiation treatment.

“Quendella’s condition is a common side effect of radiation treatment,” Dr. Shahriari said. “Prevention is key.”

For now, they have provided Ms. Davis with custom-built temporary fixed prosthesis that Dr. Marko Tadros digitally printed during her first visit. Dr. Tadros will also construct the final fixed prostheses. Before, Ms. Davis, a social media influencer with about 20,000 followers, hid her teeth from her followers using stick-on teeth she found online that made eating nearly impossible and caused her to slur when speaking.

“I haven’t been this comfortable with myself since I was a senior in high school,” she said, adding she’s now able to eat almost anything and has since begun gaining healthy weight. “My confidence is exactly where it needs to be. I can’t even believe that I’m able to smile.”