OPT findings that relate to OC (7)
Moth eaten bone
Floating teeth
Unusual bone loss
Widening of PDL
Non healing sockets
Loss of sinus/ID outline
Pathological fracture
Ultrasound findings for LN (3)
Necrosis of nodes
Enlarged nodes
Avascular nodes / increased vascularity
Advantages of CT scan
Quick
Disadvantage of CT scan
Need contrast - bloods before
Advantage of MRI
No ionising radiation
MDT cancer team (8)
- Surgeon
- Oncologist
- Pathologist
- Radiologist
- SALT
- Special care dentist
- Restorative dentist
- Psychologist
Scan for if we can’t see primary tumour
PET/CT
Role of pathologist in cancer (4)
- Diagnosis
- Extent of tumour
- Prognostic factors (molecular markers)
- Staging TNM
Role of GDP in cancer
Early detection screening
Photographs
Refer
List common dental issues that may arise during cancer tx (10)
- Oral mucositis
- Trismus
- Caries
- Perio
- Traumatic ulcers
- Reactivation of HSV
- Candida infections
- Xerostomia
- Erosion
- ORN
Management of oral mucositis (5)
Benzydamine MW
2% Lidocaine MW
Manuka honey
Saline rinse/sodium bicarb rinse
Calcium phosphate rinse
Management of candida (3)
Antifungals
- CHX
- Topical Miconazole
- Systemic Fluconazole
How does a traumatic ulcer occur in cancer patient?
Teeth rubbing against delicate I/O tissues
Management of traumatic ulcer
Smooth any sharp edges
Soft splint
Management of HSV cold sores
Systemic antivirals in prodomal period
Management for Xerostomia (5)
- F supplements
- Petroleum jelly to protect lips
- Saliva stimulants Orthana
- Prilocarpine (tachicardia/nausea)
- Sugar free gum
Cause of cancer TMJ (2)
Post surgical inflammation
Fibrosis of tissues due to radio/chemo
Management for trismus
Stretching exercises
Tongue depressors
Prevention of ORN
XLa at least 10 days prior to radiotherapy
What patients are at risk of ORN
> 60gY
Malnourished
Immunodeficient
