Dr. Patel-Cancer therapy and dentistry

Question 1

Early stage tumors of the H and N usually get treated with ______

Answer 1

surgery

Question 2

Advanced-staged tumors of the head and neck introduce what type of treatment?

Answer 2

chemoradio therapy

Question 3

What are the three main concerns for oral health care providers who are treating a patient with H&N Cancer?

Answer 3

Prevention, Infection, and ORNJ

Question 4

When is the IDEAL time to do a comp exam on a patient about to undergo tx for HandN cancer?

Answer 4

1 month before

Question 5

What are the ___ items we need to know for a med consult for a patient about to undergo radiation therapy?

Answer 5

1.TNM Staging 2.Timing of tx 3.Field of radiation 4.Dosage 5.Hx of surgery to area 6.Chemo? 7. type of radio tx

Question 6

What are three dental problems to fix before radiation therapy?

Answer 6

1.deep caries to pulp 2. perio disease 3.non-restorable teeth

Question 7

What are the main questions for a Med Consult for a patient undergoing Chemo?

Answer 7

1.Type 2.stage 3.timing 4.prognosis 5.complete blood count (neutrophils and platelets)

Question 8

When should any oral surgery done when a patient is about to undergo Chemo? (What about ANY dental treatment?)

Answer 8

at least 7-10 days before…(1 week-same thing really)

Question 9

Is there a dental treatment where you don’t need a Med Consult for a patient undergoing Chemo?

Answer 9

NO! You need a Med Consult on every treatment, even prophy

Question 10

What are the standards for neutrophil and platelet count when a patient is undergoing Chemo?

Answer 10

platelets over 50,000 and neutrophils over 1,000

Question 11

For pt’s undergoing Chemo: Monitor for _________, which is typically seen __-__ weeks after beginning chemotherapy and heals __-__ weeks after it is completed.

Answer 11

oral mucositis..1-2 weeks…2-4 weeks

Question 12

When do patients feel best after Chemo? (a good time to pick back up for routine dental care)

Answer 12

17-20 days

Question 13

What are the three types of HSCTs? Which one has the best success rate?

Answer 13

1. Autogenous (best success rate) 2.Allogentic 3.Syngenic

Question 14

What are the two paramount factors in a patient undergoing HSCT?

Answer 14

Infection and Bleeding

Question 15

What are two common oral infections in patients undergoing a HSCT?

Answer 15

Candida and Herpes

Question 16

How long do we delay ELECTIVE treatment in patients who underwent HSCT?

Answer 16

1 year

Question 17

When is the greatest risk of complications for a patient undergoing HSCT?

Answer 17

100 days. fuck.

Question 18

What are the 6 most common complications of RADIATION THERAPY?

Answer 18

1.Mucositis 2.Dysguesia 3.Xerostomia 4.ORN 5. Caries 6. Trismus

Question 19

Timing of complications from Radiation Therapy: What are the three complications that arise in the FIRST 6 weeks of therapy?

Answer 19

1.Dysgusia 2.Mucositis 3.Xerostomia

Question 20

Timing of complications from Radiation Therapy: What are the complications that typically arise after 6 weeks of therapy?

Answer 20

1.Caries 2.Trismus 3.ORN

Question 21

Timing of complications from Radiation Therapy: How long does mucositis last post therapy?

Answer 21

4 weeks, should subside

Question 22

Timing of complications from Radiation Therapy: When does osetoreadio necrosis usually show up after treatment?

Answer 22

about 1 year

Question 23

What is the amount of dose of radiation that yields complications of ORNJ?

Answer 23

greater than 60 Gy

Question 24

When does Truisms usually pop up after radiation therapy?

Answer 24

3-6 months

Question 25

What % of patients undergoing HSCT have ORAL complications?

Answer 25

80%

Question 26

What is the most common oral infection following HSCT?

Answer 26

HSV

Question 27

These are Oral manifestations of which cancer treatment?atrophy, erythema, white striations, plaques (similar to lichen planus), xerostomia, taste changes, formation of mucoceles, mucosal sclerosis

Answer 27

HSCT (GRAFT vs HOST disease)