Original Publication
Open Access

Coordinated Oral Health Care in Patients with Cancer

Published: April 2, 2013 | 10.15766/mep_2374-8265.9382

Included in this publication:

  • BOHC Toolkit.pdf
  • MedEdPORTAL Coordinated Oral Health Care in Cancer Patient.ppt
  • MedEdPORTAL Coordinated Oral Health Care in Patients with Cancer-Submission.doc

To view all publication components, extract (i.e., unzip) them from the downloaded .zip file.


Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications.

Abstract

Introduction: Cancer therapy, either with ionizing radiation or chemotherapeutic agents, is based on the principle of destruction of rapidly replicating cancer cells. Although effective in holding back or eradicating cancer growth, it also causes unavoidable damage to normal cells. The short-term and long-term effects of cancer therapy on oral and adjacent tissues can be painful, life-threatening, and intolerable to the patient. These morbidities can contribute to the disruption or discontinuance of the cancer therapy and directly affect the success of treatment. For those who survive, these morbidities adversely affect the quality of life of the patient and family members and drive up the cost of health care. Many of these complications can be minimized by good oral health care before, during, and after the cancer therapy. Advances in cancer therapy can also limit the damage to normal tissues. The key to overcoming oral complications and their consequences is the coordination of care among oral health care providers, oncologists, and other supporting groups, especially before the initiation of cancer therapy. Eliminating dormant dental infections before head and neck radiation therapy and chemotherapy has had moderate success in curtailing oral complications. Methods: This resource revisits the oral complications of conventional radiation therapy and chemotherapy. A PowerPoint presentation updates the new technology and pharmacological improvements in minimizing oral tissue damage that have arisen in recent years, as well as the interventions used to remedy such damage. The importance of the coordination of care is emphasized, and a mechanism for improving communication among the health care disciplines is provided. This resource also highlights IV bisphosphonate-associated and denosumab-associated osteonecrosis of the jaw (ONJ) in cancer patients to raise awareness of this new complication of cancer therapy. The resource provides strategies for minimizing the risk of ONJ and optimizing the outcome of cancer therapy through dental preparation before the initiation of these agents. Results: This resource has been developed and used in dental education in the field of cancer patient care. We have published our results on the effectiveness of this material elsewhere. Discussion: The resource was presented to the third and fourth dental student oral medicine courses and also converted to a section of the online clinical manual that students and faculty refer to when managing dental patients who have had cancer therapy, are undergoing it, or will undergo it in the near future. Communications with oncologists have been improved based on the instructional material in this section of the clinical manual.


Educational Objectives

By the end of this presentation, learners will be able to:

  1. Explain biomedical bases of radiation therapy for head and neck (H&N) cancer.
  2. Identify the oral health impacts of H&N radiation therapy.
  3. Describe possible complications of H&N radiation therapy.
  4. Provide strategies for prevention and/or management of complications of H&N radiation therapy.
  5. Provide strategies for improving a patient’s oral health during and after H&N radiation therapy.
  6. Explain biomedical bases of cancer chemotherapy.
  7. Identify the oral health impact of cancer chemotherapy.
  8. Describe possible complications of cancer chemotherapy.
  9. Provide rationales and strategies for prevention and/or management of complications of cancer chemotherapy.
  10. Provide strategies for improving a patient’s oral health during and after cancer chemotherapy.

Author Information

  • Rose Geist: University of Detroit Mercy School of Dentistry
  • James Geist: University of Detroit Mercy School of Dentistry

Disclosures
None to report.

Funding/Support
None to report. 



Citation

Geist R, Geist J. Coordinated oral health care in patients with cancer. MedEdPORTAL. 2013;9:9382. https://doi.org/10.15766/mep_2374-8265.9382

This publication is co-sponsored by the American Dental Education Association.