Oral Health Protocol for Head and Neck Cancer Survivors
Citation: Madhusudhan Reddy M. Oral Health Protocol for Head and Neck Cancer Survivors. Ann Med Health Sci Res. 2017; 7: 52-53
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Cancer is one of the major menaces to public health in both developed and developing countries accounting for the second most common cause of death. World Health Report 2004 reveals that cancer accounted for 7.1 million deaths in 2003 and it is estimated to increase by 50% in the next 20 years. Oral cancer is the third most common cancer in south-central Asia. The incidence of this disease in India is 12.6 per 100000 populations. Cancer risk factors include ageing, tobacco, unhealthy diet, physical inactivity and infections. . 90% of the oral cancers are due to use of tobacco, excessive consumption of alcohol and areca nut. [1,2].
Head and Neck Cancer (HNC) survival has improved in recent decades with advances in treatment. HNC survivor’s growth is continuous and alarming the challenges in management of complex medical, oral/dental and physcosocial needs of them. . Complications of head and neck cancer and their management is explained in the Table 1. [6-8].
|Complications||Symptoms and Management|
|Mucosal||Mucositis: Continuous follow up and evaluation by dental professionals, healing promotion by administering proinflammatory cytokines, prevention of trauma to the mucosa by using soft brushes|
|Pain: Administration of analgesics based on the pain severity,|
|Dysphagia: Induce salivation, artificial saliva|
|Saliva changes||Viscousity: Mucolytic agents|
|Volume: administering Sialogogues causing Serous secretions|
|Neurosensory||Neuropathic pain: Local topical analgesics, Systemic anticonvulsant and anti-depression drugs|
|Dental/periodontal||Acute exacerbation of chronic infection: evaluation and elimination of the risk factors before commencement of the cancer therapy|
|Mucosal||Candida: local and systemic antifungal drugs based on the severity of the infection|
|Herpes: antiviral drugs|
|Mucosal pain||Atrophy: Attention to hyposalivation, mucosal infection and mucositis|
|Neuropathy: Systemic anticonvulsant and anti-depression drugs, severe conditions opioid analgesics|
|Saliva||Viscousity: Mucolytic agents, hydrogen peroxide mouth rinse|
|Neurosensory||Taste alteration, taste loss: manage oral infection, oral hygiene, xerostomia and zinc supplementation|
|Halitosis: Maintenance of oral hygiene|
|Trismus: Active and passive exercise following surgical procedure|
|Mucosal||Pain: Administration of analgesics based on the pain severity|
|Halitosis: Maintenance of oral hygiene|
|Dental||Demineralization, caries: fluoride tooth pastes, topical calcium phosphate, fluoride, xylitol, chlorhedine gluconate rinse and gums or wafers|
|Periodontal||Advanced attachment loss, mobility: identify and address the risk factors prior to the cancer therapy|
|Necrosis||Osteoradionecrosis: Antibiotics, surgery including sequestrectomyerapy, hyperbaric oxygen, ozone therapy|
Table 1: Oral complications of head and neck cancer therapy and management.
Sound knowledge about the oral complication and their management of head and neck cancer treatment will help the dentists to provide best appropriate oral and dental care helping to lead good quality of life.
Conflict of Interest
All authors disclose that there was no conflict of interest.
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