The following article features coverage from the 46th Annual Oncology Nursing Society (ONS) Congress. Click here to read more of Oncology Nurse Advisor‘s conference coverage.

Several aspects of oral care for patients and survivors of head and neck cancer were discussed in an oral presentation by Olivia Muller, DDS, FACP, a maxillofacial prosthodontist at the Mayo Clinic in Rochester, Minnesota, at the 46th Annual Oncology Nurse Advisor (ONS) Congress.

“Head and neck cancer has been described as the most emotionally traumatic and psychologically distressing of all cancers,” Dr Muller said. Head and neck cancers carry unique qualities, including possible changes to one’s appearance and functional changes ranging from swallowing difficulty to an inability to return to work, she explained.

Various physical effects can occur with radiation treatment, including short-term effects, such as mucositis, and changes that affect a patient over a longer term, such as structural changes to tissue. Consequences can arise from alterations caused by treatment, such as a risk of tooth decay occurring with changes to salivary glands and tooth structure. Surgical treatments also lead to potential side effects.


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Dr Muller pointed out the importance of considering the patient’s perspective and comfort while caring for the patient, noting the stress a patient may be experiencing with the condition being treated. “You as their nursing provider can really help in pointing them in the right directions for resources,” she said, regarding further care, “and also just treating them with a sense of normalcy.” Dr Muller also explained a need to help guide patients through the pre-radiation process, with patient education being a key goal.

Regarding whether avoiding dental care during immunosuppression or neutropenia is advised, Dr Muller stated that, generally, elective care should be avoided during chemotherapy. However, if urgent or emergent care is needed, then neutropenia should be assessed and a prophylactic antibiotic given. Overall, treatment is determined on a case-by-case basis.

Dr Muller ended her presentation with a discussion on the separation between oral health vs health needs related to the rest of the body with regard to insurance coverage for dental care with head and neck cancer. Surgical dental care for disease resection, for instance, is generally covered differently than dental prosthetic care to improve oral function.

Read more of Oncology Nurse Advisor‘s coverage of the 46th Annual ONS Congress by visiting the conference page.

Reference

Muller O. Dental oncology: addressing oral care, rehabilitation, and long-term management. Oral presentation at: 46th Annual ONS Congress; April 20-29, 2021. Accessed April 26, 2021.