Head and Neck Cancer: The Role of the Dental Team Flashcards
what is the role of a GDP in screening & cancer referral?
- early detection through soft tissue examination
- photographs
- refer onwards
- pre-cancer treatment assessment (making sure patients dentally fit prior to their chemo)
what is the aim of the pre-assessment for a patient waiting to receive cancer treatment?
- identify any current oral disease and future risk of disease (want to avoid interruption to cancer treatment)
- remove infection and make dentally fit prior to therapy
- help develop plan to make sure pt oral hygiene remains good during treatment
what will you provide to a patient during a precancer treatment dental assessment?
- detailed OHI, fluoride
- dietary advice for reducing caries risk and improving comfort during treatment
- PMPR to stabilise periodontal condition
- consider chlorhexidine mw & gel (alcohol free)
- restore carious teeth, extract
- removal of trauma/sharp edges
- remove any fixed orthodontic appliances
- smoking & alcohol advice
what does cancer treatment involve?
- surgical tissue removal with/without reconstruction
- radiotherapy
- chemotherapy
what are some side effects of cancer treatment?
- surgical removal of tissues can alter anatomy and affect normal function
- radiotherapy causes unavoidable damage to normal tissues around tumour, may affect short term function (such as salivary glands etc)
- chemotherapy causes acute mucosal & haematological toxicity
- head & neck cancer treatments can affect respiration, mastication, swallowing, speech, taste, SG function
what is the dentist’s role during cancer therapy?
- hygienist support
- oral & denture hygiene
- antibacterial mw
- diet advice
- fluoride advice
- high risk of viral & fungal infections
during cancer treatment, infections are common, especially oral candida. What antifungals are effective & are they topical or systemic?
also, what antifungal is not as effective as the others?
Chlorhexidine MW
Miconazole - topical
Fluconazole - systemic
Not as effective: Nystatin - topical
during cancer treatments, oral tissues can become delicate and fragile, what are they at higher risk of?
traumatic ulceration
during cancer treatment, the immune system is weakened making the patient more prone to infections. What is a very common virus that activates itself and what does it do?
Herpes simplex virus (coldsore)
causes painful oral ulceration
during cancer treatment, salivary glands may be damaged or their functions reduced. What is this condition called and what does it lead to a higher risk of?
xerostomia
Caries, periodontal disease, candida,
during cancer treatment, salivary glands may be damaged or their functions reduced. What is this condition called and what does it lead to a higher risk of?
xerostomia
Caries, periodontal disease, candida,
what is trismus?
how can it be caused as a result of cancer treatment?
how can it be treated?
restricted or limited opening of mouth
post surgical inflammation, fibrosis of tissues as a result of chemo and radiotherapy
passive & active stretching exercises
why are you at greater risk of dental erosion after or during cancer treatment?
can be due to low saliva pH, drymouth
what part of the tooth is radiation-induced caries most likely to affect?
around the teeth (ACJ) and incisal edges
what does ORN stand for?
osteo radio necrosis
