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

2. 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.

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

5. Medical History
Social History

6. 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.

7. Alcohol Cessation – Brief Advice.

8. Extra Oral Assessment

9. Intra Oral Assessment

10. Soft Tissue Examination

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

12. Prevention Pathway

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

14. Prevent
Oral Hygiene Instruction
Diet Advice

16. Sis
Radiation caries
Mucositis

17. The Challacombe Scale
Clinical oral dryness score

18. PRPP
XEROSTOM
BIOTENE

19. BIOXTRA
SALINE & SODIUM BICARBONATE RINSE.

20. ORANURSE TOOTHPASTE.

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

22. 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

23. a
Alcohol free
But Astringent
Avoid spicy foods

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

25. Soft (very soft)
SLS Free

27. Comfort
Mastication

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

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

32. References
Briggs, J. (1998) ‘Prevention and Treatment Of Oral Mucositis In Cancer Patients’ Best Practice, 2, (3) pp.1-6. ( Rosenthal, D.I. and Trotti, (2008) ‘Strategies for Managing Radiation-Induced Mucositis in Head and Neck Cancer’ Seminars in Radiation Oncology. September,pp [online] Available from: Elsevier Inc. ( McCaul, L.K. (2012) ‘Oral and Dental Management for Head and Neck Cancer Patients Treated by Radiotherapy and Radiotherapy’ Dental Update, (March), pp

33. http://www. dentalhealth

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