Caring for oral cancer patients: Hygienists can adjust dental treatment protocols

By Kathryn Gilliam, RDH, BA

As dental professionals, we’re in a unique place to serve our patients during challenging times. We see them more often than their physicians do, and we often have deeper personal relationships. Because of this intimacy, we have the opportunity to help those who are fighting oral cancer in a very practical day-to-day way. We can give both professional and personal support that can make a significant difference in their ability to survive this devastating disease.

Before medical treatment

Perhaps you were the one who discovered the signs of oral cancer in your patient. If so, you have the opportunity to prepare the patient before treatment starts. Your part in their treatment is a quality-of-life issue as oral cancer and its treatment affects all aspects of a patient’s life.

If possible, prepare a comprehensive dental assessment before medical intervention begins. If potential issues aren’t addressed before medical treatment begins, they could cause very serious problems later1 (see sidebar titled, “Prior to cancer treatment”).

During and after medical treatment

Be extremely empathetic to cancer patients, because they are suffering. They can’t eat or swallow even saliva – if they have any – without pain. They can’t speak comfortably. Sometimes even breathing is painful if their mouths are ulcerated and dry. Often, at this point, they are not social. It’s very uncomfortable to interact with others when one can’t speak or eat. To help your patient, offer products to increase comfort and protect against further mucosal breakdown, as well as prevent caries and periodontal infection.

Several issues arise for an oral cancer patient that you can help alleviate including pain, mucositis, xerostomia, nutritional challenges, and psychosocial issues. The side effects must be cured or alleviated so the patient can continue cancer treatment (see sidebar titled, “Guidelines for pain control during cancer treatment”).