Oncology Flashcards
name 3 instances a refferal to oral medicine would be appropriate
- persistent unexplained head or neck lumps for > 3 weeks
- ulceration or unexplained swelling of oral mucosa for > 3 weeks
- all red or mixed red and white patches of oral mucosa for > 3 weeks
- dysphagia or odynophagia for > 3 weeks
- stridor (high pitched wheeze when breathing)
what should you provide for patients about to start cancer treatment (dental pre assessment) (advice)
smoking cessation
alcohol advice
detailed oral hygiene instruction
consider chlorhexidine mouthwash when in too much pain to brush
advise against wearing denture during treatment as mouth will become very tender and sore
duraphat toothpaste
what treatment should you undertake on patients about to start cancer treatment (dental pre assessment) (treatment)
- PMPR to stabilise any periodontal conditions
- definitively restore any areas of caries
remove any areas risking trauma e.g sharp edges of teeth or restorations - take impressions so that soft splints and fluoride trays can be provided down the line
- extract any teeth with dubious prognossis
- remove any fixed orthodontic appliances
- remove any sources of infection
what is the minimum number of days that should be left before a patient begins cancer treatment if you are performing a tooth extraction
no less than 10 days
what cancer treatment is oral mucositis most commonly seen as a side effect of
chemotherapy
if patient suffers oral mucositis when does it begin and last till
begins 1-2 weeks after treatment begins and can last up until 6 weeks post treatment
oral mucositis
painful inflammation and ulceration of the oral mucosa experienced by patients undergoing cancer treatment e.g chemo or radio therapy
in severe cases , pain so bed patients require hospitalisation and tube fed.
does good OH help mucositis
will not prevent symptoms but may help it resolve faster once cancer treatment complete
name 3 management options for oral mucositis
- caphosol - mouthrinse that mimics saliva and aims to relieve some pain and discomfort
- Gelclair - viscous gel that forms a protective layer over the oral mucosa aiming to offer some pain relief
- chlorhexidine mouthwash
- cryotherapy
- strong analgesics for pain control e.g opiods (doctor will prescribe)
mucositis grading scale (WHO)
grade 0 = none
1 - oral soreness and erythema
2 - erythema, ulcers but solid diet tolerated
3 - ulcers, liquid diet only
4 - oral alimentation impossible
what are your two main priorities for a patient prior to them starting chemotherapy
remove any current or potential sources of infection
institute prevention - detailed OHI , PMPR, fluoride varnish
what is used to ensure radiotherapy is only delivered to desired areas
porous mask that immobilises the patients head - individually specific to each patient
what type of radiotherapy can spare the salivary glands
intensity modulated radiotherapy (IMRT)
chemotherapy affects on the body
impaired immune system - reduced white cells
haematological effects resulting in coagulation defects
side effects of chemotherapy
alopecia
nausea
vomiting
anorexia
bone marrow suppression
reproductive function damage
mucositis
