Dental Treatment for the Cancer Patient Flashcards
What is the role of the dentist in cancer patients?
- early detection of soft tissue lesions
- pre-treatment assessment and dental care
- maintenance of oral and dental health post-treatment
- palliative care
What guidelines can we refer to when treating cancer patients?
- NICE: improving outcomes in head and neck cancers
- BAHNO/MULTIDISCIPLINARY management guidelines
- SIGN 90: diagnosis and management of head and neck cancer
What is involved in pre-cancer-treatment dental assessments?
- oral and dental assessment prior to start of cancer therapy
- radiographs
- any necessary treatment carried out
- PMPR
- impressions for soft splints
- fluoride therapy
What are the priorities of the pre treatment dental assessment in cancer patients?
- oral hygiene
- reduce treatment complications (PREVENTION)
- reduced post treatment complications (PREVENTION)
How can dental complications that interfere with cancer treatment be reduced?
- avoid unscheduled interruption of chemo regime
- avoid exacerbation of mucositis
- remove potential sources of infection
How can post-cancer-treatment dental complications be reduced?
- remove teeth of poor prognosis
- institute PREVENTION REGIME!
- plan rehabilitation
What is oral mucositis?
- inflammation and ulceration of mucosa
- severe pain
- associated with chemotherapy and radiotherapy
What can oral mucositis have an effect on?
- quality of life (extremely painful)
- eating/drinking
- oral hygiene
What general measures can be avoided to reduce likelihood of development of oral mucositis during cancer treatment?
- smoking
- spirits
- spicy foods
- tea & coffee
- non prescription mouthwash
What topic measures can be used to reduce likelihood of development of oral mucositis during cancer treatment?
- topical lignocaine
- saline mouthwash
- gelclair
- oral cooling
How does saliva change in cancer patients?
Xerostomia very common
- reduced salivary flow
- high viscosity saliva
- low pH saliva
What are the side effects of Xerostomia?
- dysphagia
- dysarthria
- dysgeusia
- poor quality of life
- increased: caries, perio disease, candidosis
How can osteoradionecrosis be prevented in cancer patients?
- remove teeth of poor prognosis in the radiotherapy field
- must be 3 weeks prior
- liaise with oncologist
- OH prevention
Why can radiotherapy cause trismus?
Fibrosis of muscles of mastication
