How far in advance of chemotherapy should invasive dental treatment ideally be completed?

Correct answer: D. At least 14 days

• A. Three days is nowhere near adequate for an extraction socket to establish early healing.
• B. A month is not mandated and would often delay life-saving oncological treatment unnecessarily.
• C. Seven days is sometimes cited as an absolute minimum for extractions where treatment cannot be delayed, but it is not the ideal target and leaves little margin.
• D. CORRECT. Two weeks is the commonly cited target. It allows mucosal and osseous healing to progress substantially before the neutrophil nadir arrives, which typically falls 7 to 14 days after the chemotherapy cycle begins. Operating into that nadir risks serious infection and impaired healing.

Note: Pre-chemotherapy protocol: comprehensive examination and full-mouth radiographs, extract non-restorable and questionable teeth at least 2 weeks ahead, eliminate sources of infection and mucosal trauma, remove orthodontic appliances, provide fluoride trays and detailed hygiene instruction. During treatment, defer elective care and treat only emergencies, checking the CBC first — an absolute neutrophil count below 1,000 or platelets below 50,000 generally means deferring and consulting the oncologist.