A patient who had breast cancer presents with large gingival recession and Class III mobility on a tooth. How do you proceed?

Correct answer: C. Referral to the patient's physician/oncologist

• A. Biopsy of gingival/bone lesion may be necessary but should be coordinated with the oncologist and should not be the first step without proper workup.
• B. Extraction without establishing the etiology — particularly in a breast cancer patient — could be dangerous if this represents metastatic disease to the jaw.
• C. A breast cancer patient with sudden gingival recession and severe tooth mobility should raise immediate concern for METASTATIC DISEASE to the jaw. Breast cancer is one of the most common cancers to metastasize to the jaws. REFERRAL TO THE PHYSICIAN/ONCOLOGIST for urgent evaluation and imaging is the priority before any dental treatment.
• D. SRP would be appropriate for periodontitis but is inadequate and potentially harmful if this is metastatic disease.