Transcript Tissue Engineering of Dental Enamel

Leeds Dental Institute
FACULTY OF MEDICINE AND HEALTH
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
• Record Smoking Status
ASK
• Inform patient of health Benefits of quitting.
ADVISE
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
Essentials of Dental Caries
Joyston – Bechal 1987
patient
Gylcerine , saliva substitute
Mc Caul,L. Dental Update 2012
dental
hygienist
Alcohol
free
a
But Astringent
Avoid spicy foods
Evidence Based Practice
Information
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 OsteoRadionecrosis
Summary
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/mucocitisrecommendations.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.org/uploads/download/resourcefiles/d
ownload_68_1_The%20Challacombe%20Scale.pdf
http://www.mouthcancer.org/
Acknowledgements
Leeds Dental Institute
Oncology team
Programme Dental Hygiene
and Dental Therapy