An Expert Explains: Oral and Dental Care for Head and Neck Cancer Patients - 2 | Transcript | Head and Neck Cancer | Patient Power


An Expert Explains: Oral and Dental Care for Head and Neck Cancer Patients

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

So I think that asking the dentist straight up, have you dealt with oncology patients before?  What do you use for that?  Are you using a remineralizing fluoride, or are you just using a fluoride supplement, or are you not going recommend fluoride at all? Am I going to have those in a carrier tray, or am I going to have to brush that on?  What can you do for mouth sores for me if they happen to come up? Is there anything that you can do to help preserve my taste?  Is there anything that you can do after the fact or during treatment?  All of these are questions that I think are very legitimate questions to ask.  It's just that patients need to know to ask them.  

I think one of the biggest things that patients need to realize is they should not allow someone to affect the bone.  That's the biggest thing.  So that's going to include pulling teeth, placing implants, using braces to move the teeth through the bone, anything that—having sometimes a periodontal surgery that would involve the bone, all of those things are necessary for the patient to discuss in detail with the practitioner who is recommending these things because it's going to be critical that whoever is doing this is fully aware of how much radiation because everything is really dose?dependent here. That area of the mouth recedes. So it's very specifically by site. 

So if we have a tooth to take out over here and radiation primarily is focused over here we need to know how much was received over here.  And the radiation oncologist can provide these types of answers to the practitioner, but they need to understand what's been done to the patient specifically. So I think that that is a big thing. 

I think that as far as what patients can expect, a lot of times you are going to have difficulty swallowing unfortunately.  And a lot of times radiation brings with it sometimes brings a necessity for a feeding tube.  I would encourage patients to try to continue to swallow as much as they can for as long as they can.  It retains the muscle memory of the swallow process, and to relearn that is very, very difficult if those muscles have the chance to atrophy and forget really how to swallow.  So I would encourage them to continue to try to swallow as long as it doesn't risk aspiration for as long as they can.  

To be aware, to be their own advocate, and to pay critical attention to their oral health.  So that means they are probably going to need to see a dentist perhaps every three months rather than every six months at least for a while until their salivary flow begins to get back to normal. Patients ask me all the time, is my a salivary gland—are they going to function again?  Is my taste going to resume?  Unfortunately, no one can really answer those questions, because everyone is different, everyone's situation is different and the treatment, even though it may be the same, has a different response in different people.  And so that variable of the unknown makes it sometimes difficult to give specifics, but in general those things do get better over time, and sometimes that can be a long time.  So the patients need to realize that it can sometimes take two to three years for some of these things to really improve.  

And so asking those kinds of questions, being that advocate, knowing that, okay, I've got a plan for this, and I've got to get through this.  I've got to kind of keep my mind in a good mode.  And I tell patients all the time, find, you know, find that spot where you are in power.  If it takes music to get you there, if it takes listening to a specific book on tape, whatever you need to kind of find that motivation, just try to get through it. 

And I think the biggest thing is to realize that it takes a support system, and if you have that support system that is your family, great.  If it's a friend, if it's a co?worker, whoever you can find, somebody that's in your church, whatever you need to do to find that critical person to kind of be there, I think that that's a great recommendation as well.  Because a lot of times if you have another set of ears and eyes to kind of see things, to be with you in the appointments if possible to kind of get this information and help write things down—it's a lot of information all at once. 

And I tell patients I realize that you're just getting bombarded with all of this info all at one time by going to all these doctors, boom, boom, boom, boom, boom.  Even though we have things that we hand them and we have things written down, I always tell our patients, listen, all you need to remember is I'm a phone call away and if you cannot, you know, if you have a problem or if you can't remember what we talked about, just call you us because we want to be there to help.  Because I think all of us really, we're compassionate about what we do, and we're sincere about that, and we want to use our experience to help the patient get through this as easily as possible.   

I just want to maybe underscore a couple of things for people.  Let's see if I got it right because I've been listening carefully. First of all, we talked about patients and maybe with their caregivers, care partners, really knowing that they can play a role in the process, not just giving it up to the doctor or the dentist, but that you can play a role.  

Part of it is working with the right people in oral health.  There may be some medicines or fluoride you mentioned and other things you can do minimize any risk of complications.  And then you said something else I thought was really interesting knowing people having radiation.  I don't think that people really think about the long?term effects of radiation, and you were saying that there may be radiation over here but it also goes over there, and that's something that's going to need to be communicated, for instance, to dentists down the road should you need a root canal or periodontal work, etc.  So knowing your records, if you will…

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Advertisement
Join Our Community Register for Events Read Our Latest Blog
Advertisement

Page last updated on October 3, 2018