Flashcards in Oral aspects of cancer care Deck (16)
what are the oral effects of radiotherapy?
- damage of healthy tissues as well as cancerous
- salivary glands/xerosotmia
- radiation caries & periodontal disease
- infections (ie candidiasis)
- loss of taste
what are the aims of local treatment?
protect local area
control secondary infection
inflammation of the mucosa
what will mucositis look like?
white/yellow fibrinous slough often with ulceration & bleeding
what will patient complain about with mucositis?
painful to eat, speak and swallow
inability to tolerate prosthesis
is mucositis a portal for microbial entry?
when is mucositis likely to heal completely?
2-3 weeks post completion cancer therapy
how to manage mucositis? 8 points
- SOFT toothbrush with F toothpaste
- chlorhexidine mouthwash if toothbrush comprimised
- hydrogen peroxide dilute mouthwash for short term
- gauze or sponge application of mouthwash
- topical analgesics or anti-inflammatory rinses, gels or ointments may be applied prior to eating
- soft, bland non-cariogenic diet at low temperature is advised
- alcohol and tobacco must be avoided
how many days after the beginning of treatment would you expect a reduction in serous gland production?
what does this reduction in serous gland production lead to?
- increased susceptibility to candidal/viral infections
- increased risk of demineralisation
- mastication and swallowing impaired
- dry friable mucosa (difficulty in tolerating prosthesis)
what is the oral management of xerostomia?
- pilocarpine therapy
- saliva substitutes (preferably with fluoride)
- water atomiser and ice chips can be soothing
- avoid dry foods and sucking on sugary sweets
- chewing sugar free gum
where will radiation caries occur mostly?
on exposed root surfaces
where do these radiation caries lesions spread to?
will encircle the neck of the teeth
is radiation caries directly related to radiation?
no, still multifactorial
oral management of radiation caries?
Intensify prevention measures
- daily fluoride application m/w or 2800ppm TP
- non-cariogenic diet
- saliva substitute