How Interdisciplinary Care Helped a Dental Patient Recover from Mouth Cancer
Daniel McDermott’s diagnosis, treatment and rehabilitation were coordinated by specialists spanning dentistry, surgery, oncology, radiology and digital prosthetics
Daniel McDermott first noticed soreness and inflammation in his gums about three years ago. His dentist referred him to several specialists, eventually leading him to Rabie M. Shanti, an associate professor of oral and maxillofacial surgery at Rutgers School of Dental Medicine’s Faculty Practice.
McDermott was diagnosed with oral squamous cell carcinoma – a cancer often misunderstood to be exclusive to smokers, but, like McDermott, about 1 in 4 are nonsmokers.
From diagnosis to rehabilitation, his care was coordinated by a network of Rutgers Health specialists spanning dentistry, surgery, oncology, radiology and digital prosthetics. This is a standard approach at Rutgers Health to deliver the most comprehensive care to patients. In June 2023, McDermott had to undergo surgery during which Shanti removed the cancer, extracted the obstructing teeth and replaced them with implants, followed by radiation therapy after the procedure.
“Without all my teeth, I had a serious lisp,” he said. “As a writer, I do public readings, I teach. I stand in front of people and talk for a living. I was really worried.”
The critical part of McDermott’s treatment was surgery, which brought in experts across disciplines. But before the operation, Heba Elkassaby, an associate professor of restorative dentistry at the school, scanned McDermott’s teeth and bite for post-op implants.
“I'm proud to say about 90% to 95% of our patients with oral cancer can have dental implants placed at the time of their surgery,” said Shanti, explaining that while not a common practice outside Rutgers Health, it’s a much safer process with a lower chance of infection and failure. “It also reduces the amount of time patients go without teeth.”
To reconstruct McDermott’s jaw, Richard Chan Woo Park, a professor of otolaryngology at Rutgers New Jersey Medical School, harvested a bone graft from McDermott’s fibula, the lower leg bone, using 3D modeling.
“3D rendering is advanced, and for the last 10 years, we've been doing this [kind of surgery here],” Park said. “I was the first person to do it at Rutgers.”
Post-surgery, radiation therapy was integrated into the care plan, led by Rutgers Cancer Institute radiation oncologist Sung Kim at the state’s only National Cancer Institute-designated Comprehensive Cancer Center together with RWJBarnabas Health. In a second surgery in December 2024, Shanti uncovered implants and removed excess tissue, aided by Elkassaby’s surgical guide.
The final phase of care brought together clinical expertise and cutting-edge technology.
Elkassaby crafted a temporary prosthesis at the school’s Georges E. Sara Digital Dentistry Center, a state-of-the-art facility with 3D printers and laboratory scanners that allowed her to adjust the prosthesis as McDermott’s tissue changed while he healed.
“These cases are extremely challenging,” said Elkassaby, who emphasized the importance of teamwork. “Our dental assistants, manager, biller – everyone plays a role. Without this interdisciplinary collaboration, including the dental lab, it wouldn’t be possible.”
The psychological toll of treatment is also significant, but so is the transformation.
“You can feel the emotional shift in patients once they receive their final prosthesis,” she said.
Now, two years after surgery, McDermott has all his prosthetic work done and is cancer-free.
“I don’t think you can look at me and tell I had surgery,” he said. “I feel normal again.”
