Cancer and SCD Flashcards
What is the role of the dentist and the dental team
early detection of soft tissue lesions
pre treatment assessment and dental care
minimal role during tx unless special interest
palliative care
What does oral cancer impact
airway
upper GI tract and major senses
What should be done pre treatment
history taking
oral and dental assessment prior to the start of cancer therapy
radiographs (OPT/PA)
any necessary treatment carried out to ensure dentally fit prior to tx
pre Treatment dental ealing by hygienist
impressions for fluoride trays
start fluoride therapy for dentate px
What are the pre treatment dental assessment priorities
OH and fluoride
reduce tx complications
reduce post tx complications
How do we reduce tx complications
avoid unscheduled interruption of chemotherapy regimen
avoid exacerbation of mucositis
remove potential sources of infection
How do we reduce post tx complications
remove teeth of dubious prognosis
institute preventive regime
plan rehabilitation
What tissues are effected by tx
skin and mucosa muscle and connective tissue saliva glands teeth and supporting structures bone
What disease results from tx effect on skin and mucosa
erythema
ulceration
mucositis
What disease results from tx effect on muscle and CT
trismus
What disease results from tx effect on saliva glands
dry mouth
What disease results from tx effect on teeth and supporting structures
dental caries and sequelae
What disease results from tx effect on bone
endarteritis obliterates
ORN
What tx may we have to provide during oncology tx
for oral ulceration
oral infection
emergency dental tx
What does mucositis result in
inflammation and ulceration severe pain analgesia required can be induced by chemo and radiotherapy impact one eating and OH
What should be avoided to manage mucositis
smoking spirits spicy foods tea and coffee non prescription M/W
What are topicals that can be used for mucositis
topical lignocaine saline m/w Na Bicarb benztdamine HCL gelclair caphosol tea tree oil mouthwash oral cooling - ice
What can help in prevention of mucositis
aloe vera amifostine chlorhexidine cryotherapy granulocyte-colony stimulating factor intravenous glutamine honey keratinocyte growth factor laser polymixin/tobramycin/amphotericin/antiobiotic pastille/paste sucralfate
What is tx for mucositis
low level laser light therapy
morphine
What infection is often seen in those who’ve cancer
oral candidiasis
What virus is often see in cancer px
reactivation of herpes simplex often intra oral and clinically atypical painful oral ulceration of sudden onset more extensive, slow healing and aggressive high index of clinic suspicion
What is the prevention in post treatment care
diet OH fluoride trismus smoking
What is the monitoring in post tx care
increased frequency of check ups
dry mouth management
prosthodontics
appropriate referral
What is the change in saliva consistency in cancer px
increase viscosity
decreased pH
will not return to normal
What can the xerostomia result in
dysphagia
dysarthria
dyspepsia
QoL
What is there an increased risk of with xerostomia
caries periodontal disease candidiosis sialadentitis prosthodontics difficulties
What is radiation induced caries
seen on smooth surfaces at necks of teeth
the decay can become circumferential and the tooth snaps off
What is the diagnosis and management for the cancer px
clinical and radiographic examination OHI scaling and root planing modern caries mangement avoidance of extraction \+/- surgery antimocrnials for acute conditions
What is prevention of osteoradionecorsis
remove any doubtful prognosis teeth in the radiotherapy field
Why does trisumus occur in cancer px
fibrosis of MoM
irreversible
What is the impact of trismus
eating speaking OH dentures dental tx
What is the role of the dental team before cancer tx
prevention of chemo/radio Rx complications
plan rehabiliation
What is the role of the dental team during cancer treatment
mucositis
emergency tx
What is the role of dental team after cancer tx
prevention
rehabilitation
