leeds dental institute faculty of medicine and health supporting the oral cancer patient. fiona...
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Leeds Dental InstituteFACULTY OF MEDICINE AND HEALTH
SUPPORTING THE ORAL CANCER PATIENT.
Fiona Heffron
Department Programme of Dental Hygiene and Therapy
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lLearning Outcomes.
• Be aware of the importance of a medical & social history.
• To recognise any extra-oral & intra-oral abnormalities.
• To compare the various products available for xerostomia and therefore select the appropriate product for the individual patient.
• To highlight the need for multidisciplinary team approach to patient care in preventing and treating oral cancer.
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The Role of the Dental Hygienist /Therapist
Support of the Oral Cancer Patient.
Before Radiotherapy Treatment
During Treatment
Post Treatment
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Medical History Social History
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Smoking Cessation – Brief Advice
ASK
• Record Smoking Status
ADVISE
• Inform patient of health Benefits of quitting.
ACT
• On patients response• Give information. Refer to local NHS Stop Smoking Services.
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Alcohol Cessation – Brief Advice.
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Extra Oral Assessment
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Intra Oral Assessment
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Soft Tissue Examination
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Screening
Basic Periodontal Examination
Caries Risk Assessment.
Extra Oral & Intra Oral Exam
Smoking
Alcohol
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Prevention Pathway
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Prior To Treatment
• Caries Prevention and Management
• Duraphat 5000ppm toothpaste
Daily Fluoride MW.
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Prevent
Oral Hygiene Instruction Diet Advice
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Sis
Radiation caries Mucositis
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The Challacombe Scale
Clinical oral dryness score
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PRPP
XEROSTOM BIOTENE
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BIOXTRASALINE & SODIUM BICARBONATE RINSE.
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ORANURSE TOOTHPASTE.
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Carers
Positive support to both carer and patient
Involving the nursing care
Multidisciplinary approach
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Management
Essentials of Dental Caries
Joyston – Bechal 1987
Gylcerine , saliva substitute
Mc Caul,L. Dental Update 2012
patient dental hygienist
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aAlcohol free
But Astringent
Avoid spicy foods
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Evidence Based Practice Information
Joanna Briggs Institute Adelaide
Oral Mucositis• Antibiotic Lozenges
• Topical anaesthetics
• Antiseptics
• Mucosal barriers
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SLS Free
Soft (very soft)
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Mastication
Comfort
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Treatment interventions
Prior to radiotherapy (ideally)
Including an oral health prevention package
Prevention of Osteo-Radionecrosis
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Summary
The individual tailored support to suit the patient
Multidisciplinary team
Evidence based advice
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ReferencesBriggs, J. (1998) ‘Prevention and Treatment Of Oral Mucositis In Cancer Patients’ Best Practice, 2, (3) pp.1-6.(http://ebd.ada.org/5907B_Oral_Cancer_Card(1).pdf))
Rosenthal, D.I. and Trotti, (2008) ‘Strategies for Managing Radiation-Induced Mucositis in Head and Neck Cancer’ Seminars in Radiation Oncology. September,pp.29-35 [online] Available from: Elsevier Inc.(http://www.oralcancerfoundation.org/dental/pdf/mucocitis-recommendations.pdf)
McCaul, L.K. (2012) ‘Oral and Dental Management for Head and Neck Cancer Patients Treated by Radiotherapy and Radiotherapy’ Dental Update, (March), pp135-139.
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http://www.dentalhealth.org/uploads/download/resourcefiles/download_68_1_The%20Challacombe%20Scale.pdf
http://www.mouthcancer.org/
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Acknowledgements
Leeds Dental Institute Oncology team
Programme Dental Hygiene and Dental Therapy
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