Oncology

Question 1

Radiotherapy side effects

Answer 1

unavoidable radiation damage to normal tissues surrounding the tumour

Question 2

aims of dental pre-assessmnet for cancer patient

Answer 2

• identifying existing oral disease and potential risk of disease
• remove infection and potential infection before start of cancer therapy
• prepare patient for expected side effects of cancer therapy
• establish adequate standard of oral hygiene to meet increasing challenges during cancer therapy
• develop plan for maintaining OH, providing preventative care, completing oral rehabilitation and follow up
• establish necessary multidisciplinary collaboration

Question 3

chemotherapy side effects

Answer 3

• acute mucosal and haematological toxicity

Question 4

possible effects of head and neck cancer treatment

Answer 4

adverse effects on
- respiration
- mastication
- speech
- taste
- swallowing
- salivary gland function
- mouth opening
- outward appearance of head and neck region

Question 5

dental issues during cancer treatment

Answer 5

• oral mucositis
• oral candida
• traumatic ulceraion
• reactivate of HSV
• xerostomia
• trismus
• dental erosion
• caries
• periodontal disease

Question 6

risk factors for osteoradionecrosis

Answer 6

• total radiation dose exceeded 60Gy
• dose fraction was large with a high number of fractions
• local trauma as a result of tooth extraction, uncontrolled periodontitis or ill-fitting denture
• person is malnourished
• pt is immunodefiecient

Question 7

Radiation caries pattern

Answer 7

• V shaped
• around cervical margin

Question 8

prevention and management of oral mucositis

Answer 8

• calcium phosphate mouth rinse
• mucoadhesive oral rinse
• soluble aspirin
• zinc supplements
• aloe vera
• cryotherapy
• Manuka honey
• intensive oral hygiene
• 2% lidocaine mouthwash prior to eating
• tea tree oil mouthwash
• morphine and opioid analgesics

Question 9

features of radiation induced caries

Answer 9

• indirect effect of non-surgical treatment
• reduced rate of salivary flow and altered salivary function in combination with high protein and calorie diet
• very common
• widespread caries

Question 10

Stage 0 ORN

Answer 10

mucosal defects only, bone exposed

Question 11

stage 1 ORN

Answer 11

radiological evidence of necrotic bone, dento-alveolar only

Question 12

stage 2 ORN

Answer 12

positive radiographic findings above ID canal with exposed bone intra-orally

Question 13

stage 3 ORN

Answer 13

clinically exposed radio necrotic bone, along with skin fistulas and infection with addition of potential or actual pathological fracture