Modern Hygienist - October 2008 - (Page 31)

SPECIAL NEEDS | patients As cancer patients are often instructed to visit their dental office before beginning radiation or chemotherapy, we as hygienists must maximize the time we have with patients in this consultation. explain instructions clearly is especially important. Printed take-home materials may be especially helpful to patients at this time. Several professional Web sites (see Download!, right) have readily available materials you can print off and provide to your patients that offer instruction on oral complications he or she might face. There also are a number of common issues and solutions you can discuss with your patients up front. Laclede’s Biotène PBF Mouthwash helps address issues with both biofilm build-up and dry mouth. Visit biotene.com for details. treatments specific to xerostomia include sucking on ice chips or sipping water frequently, use of a humidifier in the home, and use of saliva substitutes.12 Patients may also enjoy sugar-free gum or candy.13 CAN-DO COMPLIANCE In the midst of such a challenging health problem, many patients have difficulty complying with oral health instructions. One study of patients with head and neck tumors found that 76% failed to comply with a dental care regimen, and 65% did not follow oral hygiene procedures.15,16 Keeping this in mind, hygienists should do as much as possible to help patients fit oral care into their lives. Talk with your patients about their daily routines, and use what you learn to make customized suggestions. Some patients, for instance, may like to wear fluoride trays in the shower. Active patients may have an easier time using pocket-sized treatment products they can carry with them throughout the day. Patients who have mobility problems may appreciate your recommendation of a pharmacy with a mail order and automatic refill program. Hygienists can be very effective in helping patients recognize the importance and achievability of maintaining oral health. Many cancer patients meet with a long list of health professionals during their treatment. Our advice as hygienists, however, can stand out if we take the time to listen to patients’ concerns and help them create a customized plan of action. Rather than feeling overwhelmed, our patients can feel they are playing an important role in maintaining their quality of life and working toward wellness. mh Nicole Greco, BSDH, MA is the assistant Pre-clinical clinical director at New York University College of Dentistry’s dental hygiene program. She is coordinator of the prosthodontic clinic for dental hygiene students and also focuses her efforts in the area of pre-clinic instruction, ergonomics and instrumentation. She is a guest lecturer at NYU on case studies featuring periodontal disease and diabetes, and enjoys clinical dental hygiene. She is pursuing a master’s degree at Columbia with a strong interest in curriculum design. References available upon request. E-mail mh@advanstar.com. KNOWING THE TREATMENTS Supplemental fluoride is recommended for patients undergoing head and neck radiation, and may also be beneficial in cases where chemotherapeutic agents contribute to xerostomia (estimated to occur in 40 percent of patients).4,5 The dental office can fabricate a custom-fit tray in which the patient applies a pH-neutral 1% sodium fluoride gel, worn for five minutes a day.6 Patients with radiation-induced damage to salivary glands must continue these treatments for life; however, chemotherapy patients may be able to discontinue fluoride applications if their salivary flow returns after treatment.7 In addition to protecting the hard tissues, patients should also take steps to protect and cleanse soft tissues. Mucositis often manifests seven to 10 days after commencement of radiation and can continue or intensify until two to three weeks after treatment ends.8, 9 Patients should be instructed that meticulous oral hygiene is vital to reduce the chance of escalation of symptoms or infection during this time. The mouth should be cleansed at least every four hours and at bedtime.10 A 10% carbamide peroxide solution, a proven oral debriding agent and wound cleanser can be effective at killing germs and deep-cleaning gingival areas. Patients should rinse with the solution for one minute per treatment to help remove unhealthy tissue and soothe inflammation. Some treatment options for xerostomia overlap with those for mucositis; in both cases, use of mouthrinses and strict hygiene are encouraged to keep the tissues clean and moist. (Emphasize, however, that only alcohol-free mouthrinses should be used.11) Palliative GlaxoSmithKline’s Gly-Oxide Antiseptic Oral Cleanser works to kill germs and offer the deep-cleaning gingival areas need to prevent mucositis. Visit dentalprofessional.com for details. October 2008 | modern hygienist 31 http://www.biotene.com http://www.dentalprofessional.com http://www.dentalprofessional.com

Table of Contents Feed for the Digital Edition of Modern Hygienist - October 2008

Modern Hygienist - October 2008 Contents Editor's Letter Letters News Modern Solutions Trends: Homecare Trends: Perio Trends: Ergo Trends: Mid Care After Chemo Professional Rewind Esthetic Expertise: Make or Break Relationship Hands-on Hygiene: Have You Seen the Light? Going the Distance Training for Life Presi-dental Politics Ad Index Moonlighting

Modern Hygienist - October 2008

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