The SOMA (Subjective, Objective, Management, Analytic) – LENT (Late Effects of Normal Tissue) scoring system can be used to evaluate dental injury occurring as a complication following radiation and chemotherapy.
Subjective measures:
(1) pain
Objective measures:
(1) caries
Management measures:
(1) management of pain
(2) management of caries
Analytic studies:
(1) dental X-rays: assessment of necrosis progression with periapical, bite wing, panographc X-rays
(2) probe for softness: assessment of teeth for decalcification and caries
(3) pulp test: assessment for pulp integrity with heat, cold and electric current
(4) percussion: assessment of tenderness and pain
(5) mobility: assessment of alveolar bone for loss and infection
If no toxicity is present, then the 0 points are assigned.
If a toxicity is present, then the grade indicates the number of points to assign.
|
Grade 1 |
Grade 2 |
Grade 3 |
Grade 4 |
pain |
occasional and minimal |
intermittent and tolerable |
persistent and intense |
refractory and excruciating |
caries |
DMF < 25% |
SMF 25-50% |
DMF > 50% |
fracture |
management of pain |
occasional non-narcotic |
regular non-narcotic |
regular narcotic |
extraction |
management of caries |
fluoride treatments |
restoration |
selected extraction |
total extraction |
where:
• DMF = number of decayed, missing and filled teeth after therapy as compared to pre-therapy state
• I assume that "fracture" indicates bone fracture, but this seems out of place with caries.
total score =
= SUM(points for all 4 items)
LENT score =
= (total score) / 4
Interpretation:
• maximum total score: 16
• minimum LENT score: 0
• maximum LENT score: 4.0
Specialty: Hematology Oncology, Otolaryngology