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The Patient with Cancer
Approximately 40% of Americans will develop cancer in their
lifetimes. Each year, approximately 30,000 individuals develop oral cancer.
I. Types of Cancer
A. Oral and pharyngeal carcinoma
B. Non-Head and Neck Cancer
II. Dental Hygiene Care
A. Before cancer treatment:
1. Assess condition of teeth, periodontal structures, oral hygiene,
previous interest in dental care, and psychosocial factors.
2. Patients scheduled for radiation therapy to the jaw bones.
i. Teeth can never be extracted safely from irradiated bone
ii. Determine, with the dentist, which can be maintained for the life
of the patient.
3. Oral hygiene education should emphasize bacterial plaque control
and the use of oral rinses
4. Nutrition and dietary counseling are essential.
5. Tobacco cessation counseling is recommended.
6. Fluoride
i. Patients scheduled for radiation therapy to the salivary glands
need daily prescription-strength fluoride gel in brush-on form or
in custom fluoride trays.
ii. Patients with temporary xerostomia during chemotherapy may
benefit from an over-the-counter fluoride rinse or gel.
7. Instrumentation should include scaling, root planning, removal of
overhangs, and smoothing of rough restorations.
B. During cancer treatment:
1. Design alternative plaque control measures for patients with
mucositis and for patients forbidden by a physician to use a
toothbrush and floss.
2. Encourage continued fluoride application.
3. Suggest measures to relieve xerostomia, and topical
anesthetics/coating agents for mucositis.
4. Assist with the selection of nonirritating and noncariogenic foods.
5. Counsel patients with dentures on daily cleansing and removal
before sleep.
6. Continue to assist with tobacco cessation
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