MEDICALLY

COMPROMISED
PATIENT:
HEAD AND NECK

By: Kayla Garcia &

Kelsey Watson

HEAD AND NECK CANCER

Definition: a group of neoplastic diseases
in which there is transformation of normal
cells into malignant ones. When cancer
cells proliferate, the mass of abnormal
tissue that is formed enlarges until it takes
over the host site. It then sheds cells that
spread to distant sites.
Etiology: unknown
Sites for head and neck cancers: oral
cavity, pharynx, larynx, Paranasal sinuses
and nasal cavity, and salivary glands.

RISK FACTORS
Tobacco use
Alcohol use
Gender
Age
HPV
Paan (betel quid).
Mat
Preserved or salted foods

TREATMENT
Surgery
Chemotherapy
Radiation therapy
Hematopoietic cell transplantation
Hormone therapy
Vaccine therapy
Biotherapy
Combination (2 or more above)

INDICATIONS AND
CONTRAINDICATIONS FOR
DENTAL TREATMENT
Indications:
Before undergoing cancer treatments
Intensive oral care during therapy have reduced risk for
development of oral complications.
Contraindications:
Selective dental treatment during cancer therapies
No use of ultrasonic scaler during cancer treatments

IMPACT ON ORAL HEALTH

Severe oral mucositis
Xerostomia
Altered taste buds
Viral infections
Fungal infections
Dental caries
Poor oral hygiene
Trismus
Osteonecrosis of the jaw

PERIODONTAL
MANAGEMENT
Frequent recall: for the first 6 months after cancer treatment recall should be
every 4-8 weeks as needed
Saliva substitutes
Ultra-soft tooth brush
Non-alcohol mouth rinse
Fluoride: once daily fluoride gel tray usage
Monitor personal daily oral care Monitor patient for trismus
Check for pain or weakness in masticating muscles
Instruct patient to exercise 3X a day: opening/closing the mouth as far as
possible w/o pain; repeat 20X
Thor therapy

LOW LEVEL LASER THERAPY

(THOR THERAPY)
Thor therapy is indicated for use before and
after a dental extraction in a patient who has
ever undergone radiation or chemotherapy.
Thor therapy is a quick, painless procedure
that boost the oxygen content to the specific
site to promote healing and help prevent
osteonecrosis of the jaw in patients with
cancer of the head and neck.
Now the European Society for Medical
Oncology suggests using LLLT to reduce the
incidence of oral mucositis and its associated
pain, in patients receiving high-dose
chemotherapy or chemoradiotherapy.

LOW LEVEL LASER THERAPY

(THOR THERAPY)

DENTAL HYGIENE
CONSIDERATIONS
Premed: none
Patient positioning: choose whatever is most comfortable for the patient
Appointment length: short appointments for stress reduction
Conduct a legitimate head and neck exams on all patients.
Update Medical/Dental History at each appointment
Be there for support and encouragement
Thorough progress notes should include:
Cancer diagnosis, type of treatment (start & complete dates)
Name of oncologist & contact info, and any consults
Oral assessments, patient education
Any oral implications
Planned follow-up visit & plan of care w/proposed treatment outcomes.

QUESTION #1:
The cause of head and neck cancer is the
combination usage of alcohol and tobacco. It is
also more prevalent in men.
A. Both statements are true
B. Both statements are false
C. The first statement is true. The second statement is false.
D. The first statement is false. The second statement is true.

QUESTION #2:
How is head and neck cancer treated?
A. Surgery
B. It depends on the size, location, health of patient, and the
treatment objectives.
C. Radiation
D. Chemotherapy

QUESTION #3:
Always consult with the patients oncologist before
any dental treatment is performed and be sure to
write thorough progress notes each time you see the
patient.
A. Both statements are true
B. Both statements are false
C. The first statement is true. The second statement is false.
D. The first statement is false. The second statement is true.

WORKS CITED
"Low Level Laser Therapy (LLLT) Cold Laser - THOR Laser." Low
Level Laser Therapy Comes to Dentistry - THOR Laser. N.p., n.d.
Web. 29 Nov. 2016.
"Osteonecrosis of the Jaw." Osteonecrosis of the Jaw (ONJ). N.p.,
n.d. Web. 29 Nov. 2016.
Wilkins, Esther M., and Charlotte J. Wyche. Clinical Practice of the
Dental Hygienist. 11th ed. Philadelphia, PA: Wolters Kluwer
Health/Lippincott Williams & Wilkins, 2013. Print.
YouTube. YouTube, n.d. Web. 29 Nov. 2016.