Special Care Flashcards
(5 cards)
What should you explain to a pt about to have chemotherapy?
Importance of getting you dentally fit, improving OH, and looking after oral health
Remove sources of infection and avoiding exacerbation of mucositis
Essential to plan and prevent
From radiographs its evident there’s some decay and infection which needs to be under control before your treatment
What treatment is required before chemotherapy?
Perio treatment - instrumentation, OHI, reduction of risk factors
Removal of poor prognosis teeth:
- 2 weeks prior to beginning tx
- should not be carried out during chemo due to risk of spread of infection
- after chemo risk of infection, slower healing and MRONJ
Smooth down any sharp fillings or teeth to prevent trauma
Imp for soft splint to prevent any grinding
What pre-chemo prevention should be given?
OHI - brush 2x daily for at least 2 minutes with F- toothpaste 2,800ppm, use of ID brushes
Fluoride - varnish, draphat, trays to fill at night and wear
Diet - avoid spicy/hot foods, acidic drinks, fruit juice, acidic fruit, salty food
Smoking and alcohol advise if relevant
How should you manage a pt mid chemo tx?
Minimal role unless emergency/management of pathology
Mucositis - inflammation and ulceration with severe pain requiring analgesia impacting on eating and OH:
- avoid smoking, spirits, spicy food, tea, coffee, non prescription medications, topical oral cooling, use ice, lidocaine, saline, sodium bicarbonate, tea tree oil
Treat candidiasis - pseudomembranous tx with antifungals
What post-chemo palliative tx can you provide?
MRONJ risk reductions
Altered taste and sensation
Dry mouth - decreased 50-60% in first week and 20% in next 5, associated with dysphagia, dysarthria, dyspraxia
Increased risk of - caries, perio, candidiasis, sialadenitis, prosthodontics difficulty
