SUPPORTING THE ORAL CANCER PATIENT.

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Presentation transcript:

SUPPORTING THE ORAL CANCER PATIENT. Fiona Heffron Department Programme of Dental Hygiene and Therapy

lLearning Outcomes. Be aware of the importance of a medical & social history. To recognise any extra-oral & intra-oral abnormalities. To compare the various products available for xerostomia and therefore select the appropriate product for the individual patient. To highlight the need for multidisciplinary team approach to patient care in preventing and treating oral cancer.

The Role of the Dental Hygienist /Therapist Support of the Oral Cancer Patient. Before Radiotherapy Treatment During Treatment Post Treatment

Medical History Social History

Smoking Cessation – Brief Advice ASK Record Smoking Status ADVISE Inform patient of health Benefits of quitting. ACT On patients response Give information. Refer to local NHS Stop Smoking Services.

Alcohol Cessation – Brief Advice.

Extra Oral Assessment

Intra Oral Assessment

Soft Tissue Examination

Screening Basic Periodontal Examination Caries Risk Assessment. Extra Oral & Intra Oral Exam Smoking Alcohol

Prevention Pathway

Prior To Treatment Caries Prevention and Management Duraphat 5000ppm toothpaste Daily Fluoride MW.

Prevent Oral Hygiene Instruction Diet Advice

Sis Radiation caries Mucositis

The Challacombe Scale Clinical oral dryness score

PRPP XEROSTOM BIOTENE

BIOXTRA SALINE & SODIUM BICARBONATE RINSE.

ORANURSE TOOTHPASTE.

Carers Positive support to both carer and patient Involving the nursing care Multidisciplinary approach

Management Mc Caul,L. Dental Update 2012 Essentials of Dental Caries patient dental hygienist Essentials of Dental Caries Joyston – Bechal 1987 Gylcerine , saliva substitute Mc Caul,L. Dental Update 2012

a Alcohol free But Astringent Avoid spicy foods

Oral Mucositis Evidence Based Practice Information Antibiotic Lozenges Joanna Briggs Institute Adelaide Oral Mucositis Antibiotic Lozenges Topical anaesthetics Antiseptics Mucosal barriers

Soft (very soft) SLS Free

Comfort Mastication

Treatment interventions Prior to radiotherapy (ideally) Including an oral health prevention package Prevention of Osteo-Radionecrosis

Summary Multidisciplinary team Evidence based advice The individual tailored support to suit the patient Multidisciplinary team Evidence based advice

References Briggs, J. (1998) ‘Prevention and Treatment Of Oral Mucositis In Cancer Patients’ Best Practice, 2, (3) pp.1-6. (http://ebd.ada.org/5907B_Oral_Cancer_Card(1).pdf)) Rosenthal, D.I. and Trotti, (2008) ‘Strategies for Managing Radiation-Induced Mucositis in Head and Neck Cancer’ Seminars in Radiation Oncology. September,pp.29-35 [online] Available from: Elsevier Inc. (http://www.oralcancerfoundation.org/dental/pdf/mucocitis-recommendations.pdf) McCaul, L.K. (2012) ‘Oral and Dental Management for Head and Neck Cancer Patients Treated by Radiotherapy and Radiotherapy’ Dental Update, (March), pp135-139.

http://www. dentalhealth http://www.dentalhealth.org/uploads/download/resourcefiles/download_68_1_The%20Challacombe%20Scale.pdf http://www.mouthcancer.org/

Acknowledgements Leeds Dental Institute Oncology team Programme Dental Hygiene and Dental Therapy

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