Leeds Dental InstituteFACULTY OF MEDICINE AND HEALTH

SUPPORTING THE ORAL CANCER PATIENT.

Fiona Heffron

Department Programme of Dental Hygiene and Therapy

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.

The Role of the Dental Hygienist /Therapist

Support of the Oral Cancer Patient.

Before Radiotherapy Treatment

During Treatment

Post Treatment

Medical History Social History

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.

Alcohol Cessation – Brief Advice.

Extra Oral Assessment

Intra Oral Assessment

Soft Tissue Examination

Screening

Basic Periodontal Examination

Caries Risk Assessment.

Extra Oral & Intra Oral Exam

Smoking

Alcohol

Prevention Pathway

Prior To Treatment

• Caries Prevention and Management

• Duraphat 5000ppm toothpaste

Daily Fluoride MW.

Prevent

Oral Hygiene Instruction Diet Advice

Sis

Radiation caries Mucositis

The Challacombe Scale

Clinical oral dryness score

PRPP

XEROSTOM BIOTENE

BIOXTRASALINE & SODIUM BICARBONATE RINSE.

ORANURSE TOOTHPASTE.

Carers

Positive support to both carer and patient

Involving the nursing care

Multidisciplinary approach

Management

Essentials of Dental Caries

Joyston – Bechal 1987

Gylcerine , saliva substitute

Mc Caul,L. Dental Update 2012

patient dental hygienist

aAlcohol free

But Astringent

Avoid spicy foods

Evidence Based Practice Information

Joanna Briggs Institute Adelaide

Oral Mucositis• Antibiotic Lozenges

• Topical anaesthetics

• Antiseptics

• Mucosal barriers

SLS Free

Soft (very soft)

Mastication

Comfort

Treatment interventions

Prior to radiotherapy (ideally)

Including an oral health prevention package

Prevention of Osteo-Radionecrosis

Summary

The individual tailored support to suit the patient

Multidisciplinary team

Evidence based advice

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.

http://www.dentalhealth.org/uploads/download/resourcefiles/download_68_1_The%20Challacombe%20Scale.pdf

http://www.mouthcancer.org/

Acknowledgements

Leeds Dental Institute Oncology team

Programme Dental Hygiene and Dental Therapy