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Module 7 > SPECIAL CARE h+n oncology > Flashcards

SPECIAL CARE h+n oncology Flashcards

1
Q

what is the role of the dental team pre cancer treatment?

A

remove potential sources of infection so cancer treatment can proceed without delay

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2
Q

what are the adjunctive cancer treatments?

A

radiotherapy
chemotherapy
chemo-radiotherapy

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3
Q

what type of radiation does radiotherapy use?

A

ionising radiation

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4
Q

how does radiotherapy target cancer cells?

A

the ionising radiation kills the DNA of cancer cells
it also destroys healthy cells

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5
Q

what glands are sensitive to radiotherapy?

A

salivary glands

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6
Q

what are the types of radiotherapy?

A

conventional
IMRT
‘rapid arc’

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7
Q

what are the general side effects of radiotherapy (exam q)?

A

fatigue
nausea
burns
pain

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8
Q

what are the oral side effects of radiotherapy (exam q)?

A

mucositis
xerostomia
radiation caries
periodontal disease
dysgeusia/ ageusia
trismus
osteoradionecrosis

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9
Q

what is dysgeusia?

A

loss of one or more taste sensations

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10
Q

what is aguesia?

A

no taste

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11
Q

can you recover from dyguesia/ aguesia?

A

may recover after 9-18 months
may be permanent

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12
Q

what treatment may you deliver as a GDP to a pt prior to cancer tx?

A

xla of hopeless teeth
duraphat toothpaste and varnish
fluoride trays
HPT
therabite
pharmaceuticals
LLLT

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13
Q

how does mucositis present?

A

Grade 0 = No oral mucositis.
Grade 1 = Erythema and soreness.
Grade 2 = Ulcers, able to eat solids.
Grade 3 = Ulcers, requires a liquid diet (due to mucositis)
Grade 4 = Ulcers, alimentation not possible (due to mucositis

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14
Q

describe radiation caries?

A

circumferential pattern of caries on every tooth - aggressive and difficult to treat due to risk of crown fracturing off

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15
Q

what taste sensation normally remains intact with dyguesia?

A

sweet

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16
Q

what is a normal measurement of mouth opening?

A

35-55mm

17
Q

list types of teeth that would be classed as hopeless and in need of xla prior to cancer tx?

A

gross caries
mobile teeth (grade 2>)
pockets 5mm and greater
periapical pathology
furcation involvement

18
Q

what are the 2 available strengths of duraphat?

A

2800ppm
5000ppm

19
Q

how would you instruct a pt to use fluoride trays?

A

fill with duraphat toothpaste or fluoride mousse
minimum 5 min daily wear

20
Q

what devices can help pts trismus?

A

therabite
‘pat bite’
spatulas

21
Q

what pharmaceuticals can be prescribed to pts post radiation?

A

pentoxyfylline
vitamin E

22
Q

what is used for the hypoxia theory of ORN?

A

hyperbaric oxygen

23
Q

explain the hypoxia theory of ORN?

A

hyperbaric oxygen increases oxygen to damaged bone
promotes healing?
not widely available

24
Q

what is LLLT?

A

low level laser therapy
currently undergoing trials

25
Q

what should be prescribed to patients undergoing chemotherapy?

A

duraphat toothpaste and mouthwash

26
Q

what are the 3 types of chemotherapy?

A

neoadjuvant/ induction chemotherapy (before surgery)
adjuvant chemotherapy +/- radiotherapy (after surgery)
palliative chemotherapy

27
Q

how does chemotherapy work?

A

using drugs to kill rapidly dividing cells
interferes with mitosis
interferes with apoptosis
interferes with tumour cell DNA

28
Q

name 3 chemotherapy drugs?

A

cisplatin
cetuximab
TPF

29
Q

what are the general side effects of chemotherapy drugs?

A

fatigue
nausea
vomiting+diarrhoea
skin rash
hair loss
thrombocytopenia
neutropenia

30
Q

what are the oral side effects of chemotherapy drugs?

A

mucositis
infection
bleeding
temporary zerostomia?

31
Q

what can we do as dental professionals for a pt with mucositis?

A

soft splints
caphosol
LLLT?
HPT before chemo starts

32
Q

what is caphosol?

A

Caphosol is a calcium phosphate solution resembling human saliva that is intended to replace the normal ionic and pH balance in the oral cavity. It has been used as a mouth rinse to moisten, lubricate, and clean the oral mucosa, tongue, and throat.

33
Q

what must be checked if XLA is needed during/ soon after chemotherapy?

A

blood test - FBC, coag screen

34
Q

what is thrombocytopenia?

A

low platelets = no clotting

35
Q

what is neutropenia?

A

low neutrophils = immunosuppressed

36
Q

what is HPT?

A

hygiene based therapy

37
Q

what is pentoxifylline?

A

vasodilator

38
Q

name a brand of flavour free toothpaste?

A

oronurse

39
Q

what ingredient in toothpaste can pts who have just had radiotherapy not tend to tolerate?

A

sodium lauryl sulphate

Module 7 (52 decks)

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