Role of the Dentist Flashcards
what signs/symptoms may indicate a H&N cancer referral?
whats the role of GDP for cancer?
Screening & Referral
- early detection through soft tissue exam
- photographs
- onward referral
- pre-treatment assessment
Pt has cancer, what should the pre-tx dental assessment include?
- full detailed exam
- radiographs (OPT, PA)
- identify & control current disease
- remove risk of infection/potential infection before cancer tx
- establish good OH
what is provided in dental assessment for precancer tx?
- OHI
- Fluoride (topical)
- Diet advice
- PMPR (perio)
- Caries management
- removal of trauma things like sharp teeth
what happens to orthodontics during cancer tx?
- discontinue & remove fixed appliances
what types of cancer tx can a pt receive?
- surgical resection with or without reconstruction
- radiotherapy
- chemotherapy
side effects of a pt receiving cancer tx?
- surgical resection can produce alterations to normal anatomy (affect function and appearance)
- radiotherapy causes unavoidable radiation damage to normal tissues surrounding tumour, may affect function of these tissues
- chemo, causes acute mucosal & haematological toxicity, it can be exaggerated if radiotherapy given combined
H&N cancer can affect respiration, eating, swallowing, speech, taste, SG function etc
during cancer therapy, what is dentists role?
- hygienist support
- Oral & denture hygiene
- Diet advice
- Fluoride
- High risk of viral/fungal infections
- Tx/symptomatic relief of mucositis, xerostomia
management of oral mucositis?
- aloe vera
- Benzydamine spray (difflam)
- analgesics
- good OH
candida infections during cancer tx?
- common & extremely uncomfortable
- antifungals prescribed (Miconazole, fluconazole, nystatin)
what dental issues can occur during cancer tx?
- traumatic ulceration (teeth rubbing)
- reactivation of Herpes simplex
- xerostomia
- trismus
- dental erosion (glandosane, acidic drinks)
- caries (radiation induced too)
- perio
- ORN
cause & management of xerostomia from cancer tx?
- ionising radiation damage SG in radiotherapy fields
- saliva replacements, frequent sip of water
- avoid glandosane (acidic saliva replacement)
Prevention & tx of patients who have received/receiving cancer tx?
- regular exams (<6monthly)
- catch early pathology
- radiographs
- hygienists
- avoid invasive tx
- caries management
- antimicrobials for acute conditions
what can be used for reconstruction & maintenance for cancer pts?
Implants
- requires maintenance
- specialist in restorative will plan and place
Dentures
- should be avoided where possible
- denture hygiene essential (candida risk)
Obturators
- they plug the hole if tissues been excised
- daily cleaning manditory
