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Supportive Care in Cancer
Published in: Supportive Care in Cancer 7/2014

01-07-2014 | Original Article

Appropriate and necessary oral care for people with cancer: guidance to obtain the right oral and dental care at the right time

Authors: Joel B. Epstein, Pelin Güneri, Andrei Barasch

Published in: Supportive Care in Cancer | Issue 7/2014

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Abstract

Purpose

The identification of experienced and knowledgeable dental specialists to provide appropriate oral care for cancer patients, as well as the integration of this care within general oncology management, may be a challenge. This paper discusses the general and additional requirements for dental care providers to support the cancer patient and provide prevention and/or treatment for oral complications of cancer therapy.

Methods

We performed a literature review of specific issues regarding the oral cavity and adjacent structures in the cancer patient, including detection and early diagnosis of oral malignancy. We incorporated the systemic effects of cancer and its therapy that affect oral disease and treatment. We present a summary of how to seek expert dental care for cancer patients and for referral from the dental and medical community.

Results

Due to the complexity conferred by the disease and its treatment, cancer patients require educated, experienced dentists for treatment and/or prevention of oral-related morbidity. Correct diagnosis and evidence-based prophylactic and therapeutic oral care can significantly improve patient quality of life and reduce morbidity and healthcare costs.

Conclusions

The knowledge and expertise of dental professionals regarding prevention/treatment of complications and secondary malignant lesions in cancer patients are critical. Integration of oral care with the oncology care and in survivors requires effective communication between dental and medical providers beginning ideally at diagnosis. These clinicians may be identified at the cancer center, nearby hospital dental programs, and, less commonly, in the community.
Literature
1.
Hancock PJ, Epstein JB, Sadler GR (2003) Oral and dental management related to radiation therapy for head and neck cancer. J Can Dent Assoc 69:585–590PubMed
2.
Epstein JB, Thariat J, Bensadoun RJ, Barasch A, Murphy BA, Kolnick L, Popplewell L, Maghami E (2012) Oral complications of cancer and cancer therapy: from cancer treatment to survivorship. CA Cancer J Clin 62:400–422PubMedCrossRef
3.
4.
Bueno AC, Ferreira RC, Barbosa FI, Jham BC, Magalhães CS, Moreira AN (2013) Periodontal care in patients undergoing radiotherapy for head and neck cancer. Support Care Cancer 21:969–975PubMedCrossRef
5.
Hong CH, Napeñas JJ, Hodgson BD, Stokman MA, Mathers-Stauffer V, Elting LS, Spijkervet FK, Brennan MT, Dental Disease Section, Oral Care Study Group, Multi-National Association of Supportive Care in Cancer (MASCC)/International Society of Oral Oncology (ISOO) (2010) A systematic review of dental disease in patients undergoing cancer therapy. Support Care Cancer 18:1007–1021PubMedCentralPubMedCrossRef
6.
7.
Ray-Chaudhuri A, Shah K, Porter RJ (2013) The oral management of patients who have received radiotherapy to the head and neck region. Br Dent J 14:387–393CrossRef
8.
Epstein JB, Robertson M, Emerton S, Phillips N, Stevenson-Moore P (2001) Quality of life and oral function in patients treated with radiation therapy for head and neck cancer. Head Neck 23:389–398PubMedCrossRef
9.
Djuric M, Hillier-Kolarov V, Belic A, Jankovic L (2006) Mucositis prevention by improved dental care in acute leukemia patients. Support Care Cancer 14:137–146PubMedCrossRef
10.
Brouwers M, Crawford J, Elison P, Evans WK, Gagliardi A, Holmes D, Lacourciere J, Lo D, Mai V, McNair S, Minuk T, Oliver TK, Rabeneck L, Rand C, Ross J, Smylie J, Srigley J, Stern H, Trudeau M (2007) Organizational standards for diagnostic assessment programs. Toronto (ON): Cancer Care Ontario [In review 2011]. Program in Evidence-based Care Evidence-based Series Organizational Standards for DAP IN REVIEW
11.
Rogers SN, El-Sheikha J, Lowe D (2009) The development of a patients concerns inventory (PCI) to help reveal patients concerns in the head and neck clinic. Oral Oncol 45:555–561PubMedCrossRef
12.
Soga Y, Sugiura Y, Takahashi K, Nishimoto H, Maeda Y, Tanimoto M, Takashiba S (2010) Progress of oral care and reduction of oral mucositis—a pilot study in a hematopoietic stem cell transplantation ward. Support Care Cancer 19:303–307PubMedCrossRef
13.
Jones DL, Rankin KV (2012) Management of the oral sequelae of cancer therapy. Tex Dent J 129:461–468PubMed
14.
Patel Y, Bahlhorn H, Zafar S, Zwetchkenbaum S, Eisbruch A, Murdoch-Kinch CA (2012) Survey of Michigan dentists and radiation oncologists on oral care of patients undergoing head and neck radiation therapy. J Mich Dent Assoc 94:34–45PubMed
15.
Vijay Kumar KV, Suresan V (2012) Knowledge, attitude and screening practices of general dentists concerning oral cancer in Bangalore city. Indian J Cancer 49:33–38PubMedCrossRef
16.
Funk CS, Warmling CM, Baldisserotto J (2013) A randomized clinical trial to evaluate the impact of a dental care program in the quality of life of head and neck cancer patients. Clin Oral Investig PMID: 23989505
17.
Ho MW, Field EA, Field JK, Risk JM, Rajlawat BP, Rogers SN, Steele JC, Triantafyllou A, Woolgar JA, Lowe D, Shaw RJ (2013) Outcomes of oral squamous cell carcinoma arising from oral epithelial dysplasia: rationale for monitoring premalignant oral lesions in a multidisciplinary clinic. Br J Oral Maxillofac Surg 51:594–599PubMedCrossRef
18.
Kashiwazaki H, Matsushita T, Sugita J, Shigematsu A, Kasashi K, Yamazaki Y, Kanehira T, Yamamoto S, Kondo T, Endo T, Tanaka J, Hashino S, Nishio M, Imamura M, Kitagawa Y, Inoue N (2012) Professional oral health care reduces oral mucositis and febrile neutropenia in patients treated with allogeneic bone marrow transplantation. Support Care Cancer 20:367–373PubMedCrossRef
19.
Bellm LA, Epstein JB, Rose-Ped A, Martin P, Fuchs HJ (2000) Patient reports of complications of bone marrow transplantation. Support Care Cancer 8:33–39PubMed
20.
Citak E, Tulek Z (2013) Longitudinal quality of life in Turkish patients with head and neck cancer undergoing radiotherapy. Support Care Cancer 21:2171–2183PubMedCrossRef
21.
Turner L, Mupparapu M, Akintoye SO (2013) Review of the complications associated with treatment of oropharyngeal cancer: a guide for the dental practitioner. Quintessence Int 44:267–279PubMedCentralPubMed
22.
Gautam AP, Fernandes DJ, Vidyasagar MS, Maiya AG, Nigudgi S (2013) Effect of low-level laser therapy on patient reported measures of oral mucositis and quality of life in head and neck cancer patients receiving chemoradiotherapy—a randomized controlled trial. Support Care Cancer 21:1421–1428PubMedCrossRef
23.
Epstein JB, Stevenson-Moore P (2001) Periodontal disease and periodontal management in patients with cancer. Oral Oncol 37:613–619PubMedCrossRef
24.
Barker GJ, Epstein JB, Williams KB, Gorsky M, Raber-Durlacher JE (2005) Current practice and knowledge of oral care for cancer patients: a survey of supportive health care providers. Support Care Cancer 13:32–41PubMedCrossRef
25.
Springer IN, Niehoff P, Warnke PH, Böcek G, Kovács G, Suhr M, Wiltfang J, Açil Y (2005) Radiation caries—radiogenic destruction of dental collagen. Oral Oncol 41:723–728PubMedCrossRef
26.
Nguyen NP, Moltz CC, Frank C, Vos P, Smith HJ, Karlsson U, Nguyen LM, Rose S, Dutta S, Sallah S (2006) Evolution of chronic dysphagia following treatment for head and neck cancer. Oral Oncol 42:374–380PubMedCrossRef
27.
Ben-David MA, Diamante M, Radawski JD, Vineberg KA, Stroup C, Murdoch-Kinch CA, Zwetchkenbaum SR, Eisbruch A (2007) Lack of osteoradionecrosis of the mandible after intensity-modulated radiotherapy for head and neck cancer: likely contributions of both dental care and improved dose distributions. Int J Radiat Oncol Biol Phys 68:396–402PubMedCentralPubMedCrossRef
28.
Epstein JB, Parker IR, Epstein MS, Gupta A, Kutis S, Witkowski DM (2007) A survey of National Cancer Institute-designated comprehensive cancer centers’ oral health supportive care practices and resources in the USA. Support Care Cancer 15:357–362PubMedCrossRef
29.
Keefe DM, Schubert MM, Elting LS, Sonis ST, Epstein JB, Raber-Durlacher JE, Migliorati CA, McGuire DB, Hutchins RD, Peterson DE (2007) Mucositis Study Section of the Multinational Association of Supportive Care in Cancer and the International Society for Oral Oncology Updated clinical practice guidelines for the prevention and treatment of mucositis. Cancer 1:820–831CrossRef
30.
Boroumand S, Garcia AI, Selwitz RH, Goodman HS (2008) Knowledge and opinions regarding oral cancer among Maryland dental students. J Cancer Educ 23:85–91PubMedCrossRef
31.
Porter SR, Fedele S, Habbab KM (2010) Xerostomia in head and neck malignancy. Oral Oncol 46:460–463PubMedCrossRef
32.
Rogers SN (2010) Quality of life perspectives in patients with oral cancer. Oral Oncol 46:445–447PubMedCrossRef
33.
Barasch A, Epstein JB (2011) Management of cancer therapy induced oral mucositis. Dermatol Ther 24:424–431PubMedCrossRef
34.
Bensadoun RJ, Patton LL, Lalla RV, Epstein JB (2011) Oropharyngeal candidiasis in head and neck cancer patients treated with radiation: update 2011. Support Care Cancer 19:737–744PubMedCrossRef
35.
Jager-Wittenaar H, Dijkstra PU, Vissink A, van Oort RP, van der Laan BF, Roodenburg JL (2011) Malnutrition in patients treated for oral or oropharyngeal cancer—prevalence and relationship with oral symptoms: an explorative study. Support Care Cancer 19:1675–1683PubMedCentralPubMedCrossRef
36.
Mosel DD, Bauer RL, Lynch DP, Hwang ST (2011) Oral complications in the treatment of cancer patients. Oral Dis 17:550–559PubMedCrossRef
37.
Watters AL, Epstein JB, Agulnik M (2011) Oral complications of targeted cancer therapies: a narrative literature review. Oral Oncol 47:441–448PubMedCrossRef
38.
Kühl S, Walter C, Acham S, Pfeffer R, Lambrecht JT (2012) Bisphosphonate-related osteonecrosis of the jaws—a review. Oral Oncol 48:938–947PubMedCrossRef
39.
Lyons AJ, Crichton S, Pezier T (2013) Trismus following radiotherapy to the head and neck is likely to have distinct genotype dependent cause. Oral Oncol 49:932–936PubMedCrossRef
40.
Nicolatou-Galitis O, Sarri T, Bowen J, Di Palma M, Kouloulias VE, Niscola P, Riesenbeck D, Stokman M, Tissing W, Yeoh E, Elad S, Lalla RV, For The Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/ International Society of Oral Oncology (MASCC/ISOO) (2013) Systematic review of amifostine for the management of oralmucositis in cancer patients. Support Care Cancer 21:357–364PubMedCrossRef
41.
Kuchuk I, Mazzarello S, Butterfield K, Appleton A, Addison CL, Clemons M (2013) Oral care and the use of bone-targeted agents in patients with metastatic cancers: a practical guide for dental surgeons and oncologists. J Bone Oncol 2:38–46CrossRef
42.
Glenny AM, Gibson F, Auld E, Coulson S, Clarkson JE, Craig JV, Eden OB, Worthington HV, Pizer B, UKCCSG-PONF Mouth Care Group (2004) A survey of current practice with regard to oral care for children being treated for cancer. Eur J Cancer 40:1217–1224PubMedCrossRef
43.
Epstein JB, Nantel S, Sheoltch SM (2000) Topical azathioprine in the combined treatment of chronic oral graft-versus-host disease. Bone Marrow Transplant 25:683–687PubMedCrossRef
44.
Stoopler ET (2013) Management of oral chronic graft-versus-host disease. J Can Dent Assoc 79:d37PubMed
45.
Mealey BL, Semba SE, Hallmon WW (1994) The head and neck radiotheraphy patient: Part 2—management of oral complications. Compendium 15:442, 444, 446–452, passim; quiz 458
46.
Andrews N, Griffiths C (2001) Dental complications of head and neck radiotherapy: part 1. Aust Dent J 46:88–94PubMedCrossRef
47.
McGuire DB (2003) Barriers and strategies in implementation of oral care standards for cancer patients. Support Care Cancer 11:435–441PubMedCrossRef
48.
Louise Kent M, Brennan MT, Noll JL, Fox PC, Burri SH, Hunter JC, Lockhart PB (2008) Radiation-induced trismus in head and neck cancer patients. Support Care Cancer 16:305–309PubMedCrossRef
49.
Brennan MT, Elting LS, Spijkervet FK (2010) Systematic reviews of oral complications from cancer therapies, Oral Care Study Group, MASCC/ISOO: methodology and quality of the literature. Support Care Cancer 18:979–984PubMedCrossRef
50.
Nicolatou-Galitis O, Kouloulias V, Sotiropoulou-Lountou A, Dardoufas K, Polychronopoulou A, Athanassiadou P, Kolitsi G, Kouvaris J (2011) Oral mucositis, pain and xerostomia in 135 head and neck cancer patients receiving radiotherapy with or without chemotherapy. Open Cancer J 4:7–17CrossRef
51.
Cooperstein E, Gilbert J, Epstein JB, Dietrich MS, Bond SM, Ridner SH, Wells N, Cmelak A, Murphy BA (2012) Vanderbilt head and neck symptom survey version 2.0: report of the development and initial testing of a subscale for assessment of oral health. Head Neck 34:797–804PubMedCrossRef
52.
Roe JW, Carding PN, Rhys-Evans PH, Newbold KL, Harrington KJ, Nutting CM (2012) Assessment and management of dysphagia in patients with head and neck cancer who receive radiotherapy in the United Kingdom—a web-based survey. Oral Oncol 48:343–348PubMedCrossRef
53.
54.
Güneri P, Cankaya H, Yavuzer A, Güneri EA, Erişen L, Ozkul D, El SN, Karakaya S, Arican A, Boyacioğlu H (2005) Primary oral cancer in a Turkish population sample: association with sociodemographic features, smoking, alcohol, diet and dentition. Oral Oncol 41:1005–1012PubMedCrossRef
55.
Fernandes LL, Torres SR, Garnica M, de Souza Gonçalves L, Junior AS, de Vasconcellos AC, Cavalcanti W, Maiolino A, de Barros Torres MC (2013) Oral status of patients submitted to autologous hematopoietic stem cell transplantation. Support Care Cancer 22:15–21, PMID: 23975228PubMedCrossRef
56.
Lawrence M, Aleid W, McKechnie A (2013) Access to dental services for head and neck cancer patients. Br J Oral Maxillofac Surg 51:404–407PubMedCrossRef
57.
Barasch A, Cunha-Cruz J, Curro F, Derouen T, Gilbert GH, Hujoel P, Safford MM, Vena DA, Voinea-Griffin AE, Wu H, CONDOR Collaborative Group (2013) Dental risk factors for osteonecrosis of the jaws: a CONDOR case-control study. Clin Oral Investig 17:1839–1845PubMedCrossRef
58.
Chang JS, Lo HI, Wong TY, Huang CC, Lee WT, Tsai ST, Chen KC, Yen CJ, Wu YH, Hsueh WT, Yang MW, Wu SY, Chang KY, Chang JY, Ou CY, Wang YH, Weng YL, Yang HC, Wang FT, Lin CL, Huang JS, Hsiao JR (2013) Investigating the association between oral hygiene and head and neck cancer. Oral Oncol. doi:10.​1016/​j.​oraloncology.​ 2013.​07.​004 PubMedCentral
59.
60.
Elad S, Thierer T, Bitan M, Shapira MY, Meyerowitz C (2008) A decision analysis: the dental management of patients prior to hematology cytotoxic therapy or hematopoietic stem cell transplantation. Oral Oncol 44:37–42PubMedCrossRef
61.
Jacobson JJ, Epstein JB, Eichmiller FC, Gibson TB, Carls GS, Vogtmann E, Wang S, Murphy B (2012) The cost burden of oral, oral pharyngeal, and salivary gland cancers in three groups: commercial insurance, Medicare, and Medicaid. Head Neck Oncol 4:15. doi:10.​1186/​1758-3284-4-15, PubMed PMID: 22537712; PubMed Central PMCID: PMC3503554PubMedCentralPubMedCrossRef
62.
Ghazali N, Kanatas A, Langley DJ, Scott B, Lowe D, Rogers SN (2011) Treatment referral before and after the introduction of the Liverpool patients concerns inventory (PCI) into routine head and neck oncology outpatient clinics. Support Care Cancer 19:1879–1886PubMedCrossRef
63.
McGuire DB, Correa ME, Johnson J, Wienandts P (2006) The role of basic oral care and good clinical practice principles in the management of oral mucositis. Support Care Cancer 14:541–547PubMedCrossRef
64.
Alpöz E, Güneri P, Epstein JB, Cankaya H, Osmic D, Boyacıoğlu H (2013) Dental students’ knowledge of characteristics and management of oral complications of cancer therapy. Support Care Cancer 21(10):2793–2798. doi:10.​1007/​s00520-013-1856-x, Epub 2013 Jun 1. PubMed PMID: 23729227PubMedCrossRef
65.
Eckardt A, Barth EL, Kokemueller H, Wegener G (2004) Recurrent carcinoma of the head and neck: treatment strategies and survival analysis in a 20-year period. Oral Oncol 40:427–432PubMedCrossRef
66.
Rethman MP, Carpenter W, Cohen EEW, Epstein J, Evans CA, Flaitz CM, Graham FJ, Hujoel PP, Kalmar JR, Koch WM, Lambert PM, Lingen MW, Oettmeier BW Jr, Patton LL, Perkins D, Reid BC, Sciubba JJ, Tomar SL, Wyatt AD Jr, Aravamudhan K, Frantsve-Hawley J, Cleveland JL, Meyer DM, for the American Dental Association Council on Scientific Affairs, Expert Panel on Screening for Oral Squamous Cell Carcinomas (2010) Evidence-based clinical recommendations regarding screening for oral squamous cell carcinomas. J Am Dent Assoc 141:509–520PubMedCrossRef
67.
Groome PA, Rohland SL, Hall SF, Irish J, Mackillop WJ, O’Sullivan B (2011) A population-based study of factors associated with early versus late stage oral cavity cancer diagnoses. Oral Oncol 47:642–647PubMedCrossRef
68.
Cankovic M, Ilic MP, Vuckovic N, Bokor-Bratic M (2013) The histological characteristics of clinically normal mucosa adjacent to oral cancer. J Cancer Res Ther 9:240–244PubMedCrossRef
69.
Jégu J, Binder-Foucard F, Borel C, Velten M (2013) Trends over three decades of the risk of second primary cancer among patients with head and neck cancer. Oral Oncol 49:9–14PubMedCrossRef
70.
Güneri P, Epstein J, Botto RW (2013) Breaking bad medical news in a dental care setting. J Am Dent Assoc 144:381–386PubMedCrossRef
71.
Corrigan DM, Walker MP, Liu Y, Mitchell TV (2013) Factors influencing patients seeking oral health care in the oncology dental support clinic at an urban university dental school setting. Spec Care Dentist. doi:10.​1111/​scd.​12037 PubMed
72.
Epstein JB, Parker IR, Epstein MS, Stevenson-Moore P (2004) Cancer-related oral health care services and resources: a survey of oral and dental care in Canadian cancer centres. J Can Dent Assoc 70:302–304PubMed
73.
74.
Güneri P, Cankaya H, Kaya A, Boyacioğlu H (2008) Turkish dentists’ knowledge of head and neck cancer therapy-related complications: implications for the future. Eur J Cancer Care (Engl) 17:84–92
75.
Burke L, Croucher R (1996) Criteria of good dental practice generated by general dental practitioners and patients. Int Dent J 46:3–9PubMed
76.
Kim MJ, Damiano PC, Hand J, Denehy GE, Cobb DS, Qian F (2012) Consumers’ choice of dentists: how and why people choose dental school faculty members as their oral health care providers. J Dent Educ 76:695–704PubMed
Metadata
Title
Appropriate and necessary oral care for people with cancer: guidance to obtain the right oral and dental care at the right time
Authors
Joel B. Epstein
Pelin Güneri
Andrei Barasch
Publication date
01-07-2014
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 7/2014
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-014-2228-x

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