Week 5- Oral Complications Flashcards
What are effects of tumour metabolites?
- Facial flushing
- Pigmentations
- Amyloidosis
- Oral erosions
What are some potential changes caused by functional disturbances if pt has cancer?
- Purpura
- Bleeding
- Infections
- Anaemia
What is radiotherapy?
Ionising radiation therapy used to control/kill malignant cells by damaging DNA
What are radiation effects to skin and mucosa?
Erythema
Ulceration
Mucositis
What are radiation effects to muscle and connective tissue?
- Trismus
- Limited access for self care and operative care
What are radiation effects to bone?
ORN
Obliterans
Endarteritis
What are oral complications of radiotherapy?
- Mucositis
- Ulceration
- Candidosis
- Xerostomia
- Radiation caries
- Loss of taste
- Dental hypersensitivity
- Perio
- Trismus
- ORN
- Craniofacial defects
What is this?
Osteoradionecrosis
Why can’t bone heal following radiation therapy?
Radiation kills osteocytes
What are dental pre-radiotherapy considerations?
- OH/Prevention/Restorative Care
- Risk/benefit of retaining teeth
- Dental exrtactions
How is radiation administered to help prevent permanently damaging healthy tissues?
Fractionations
What are dental considerations for during radiotherapy treatment?
- Discourage Smoking & Alcohol
- Eliminate Infections
- Relieve Mucositis
- Saliva Substitutes
- Physiotherapy for Trismus
What are dental considerations for during radiotherapy treatment?
- Discourage smoking and alcohol
- Eliminate infections
- Relieve mucositis
- Saliva substitutes
- Physiotherapy for trismus
What are dental considerations after radiotherapy?
- Continue OH/preventative care
- Antibiotics for infections
- Specialist OMFS for exos/oral surgery
- Topical fluoride
- Avoid mucosal trauma
- Saliva substitutes
What are characteristics of chemotherapy?
- Cytotoxic anti-cancer drugs
- Kill rapidly dividing cells
- Single agent/combination
What are oral complications of chemotherapy?
- Infections
- Ulcers & mucositis
- Lip cracking
- Bleeding
- Xerostomia
- Perio disease
- Delayed/abnormal development
What is required before chemotherapy?
- Oral and dental assessment
- Oral hygiene
What are considerations for during chemotherapy?
- Folic acid to reduce ulcers
- Ice cold water/sucking ice
- Diluted CHX mouthwash
- Nystatin for candidosis
- Acyclovir for herpetic infection
- Antibiotics for infections
- Methotrexate interaction with NSAIDs/Aspirin
What is methotrexate used to treat?
Rheumatoid arthritis
What are considerations for after chemotherapy?
- OH/Preventative dentistry
- Risk of anaemia/bleeding/infection
What is one of the main reasons pts stop chemotherapy and radiotherapy?
Oral mucositis
What are characteristics of oral mucositis?
- Widespread erythema
- Ulceration
- Soreness & bleeding
What is this?
Oral Mucositis
What is the WHO scale for mucositis?
- Soreness / Erythema
- Erythema & ulcers / Able to eat solids
- Ulcers / Requires liquid diet
- Oral intake not possible
