Feeling whole again
Date: November 30, 2010
The wounds from head and neck cancers aren’t just physical—they can be deeply emotional as well, especially for patients who require ablative surgery.
“It’s a huge psychic blow for patients who need to have a significant portion of their face removed to save their lives,” says dentist Marvin (Max) Baer.
Baer, whose aesthetic appreciation and love of working with his hands led him to a career in dentistry decades ago, designs maxillofacial prosthetic appliances that fit inside patients’ mouths, filling in holes in their palates and jaws and replacing missing teeth.
Before surgery takes place, Baer and his team model a patient’s mouth to develop a temporary prosthesis that will feel comfortable and familiar to the patient and can be placed right away after surgery. They often accompany surgeons into the operating room to better tailor the prosthesis while surgery is under way. This initial device mainly closes any new defect in a patient’s hard palate.
Once Baer and his colleagues know the surgery’s outcome, including how much of the hard palate and jaw and how many teeth were lost, they design an intermediate prosthesis complete with teeth which is delivered 10 to 14 days after surgery. Six months to a year later, the patient receives a final prosthesis that takes into account any tissue changes that occurred with radiation, further treatment or healing.
Baer explains that without a prosthesis in place, a defect in the hard palate can make everyday living a struggle. “Patients can’t eat or drink, and their speech can be completely unintelligible,” he says. “There can be a huge stigma that comes from feeling disfigured. A prosthesis can significantly increase quality of life for these patients.”
Expertise like Baer’s is relatively rare—there are only around 200 maxillofacial prosthodontists in the United States. Baer says the high volume of patients he and his colleague see at Johns Hopkins have given him and his team a unique knowledge base and versatility to create devices that fill a patient’s needs, both physically and emotionally.
“It’s very rewarding,” he says, “to know that we can provide that psychological lift to patients and help them feel whole again.”
To refer a patient, call 410-955-6663.

