The National Institutes of Health report that more than one million new cases of cancer are diagnosed each year.¹

Accordingly, each of us must be prepared to educate and motivate patients to be proactive in caring for their oral health. By emphasizing the benefits of good homecare, we can empower our patients to take an active role in their treatment and prevent additional complications.

As cancer patients are often instructed to visit their dental office before beginning radiation or chemotherapy, we as hygienists must maximize the time we have with patients in this consultation, keeping in mind that they may not be able to return to the dental office for some time. Patients who have just been diagnosed often feel overwhelmed, stressed and confused by this initial flurry of health consultations, so taking the time to listen and explain instructions clearly is especially important. Printed take-home materials may be especially helpful to patients at this time. Several professional Web sites have readily available materials you can print off and provide to your patients that offer instruction on oral complications he or she might face. There also are a number of common issues and solutions you can discuss with your patients up front.

In addition to protecting the hard tissues, patients should also take steps to protect and cleanse soft tissues. Mucositis often manifests seven to 10 days after commencement of radiation and can continue or intensify until two to three weeks after treatment ends.^{8, 9} Patients should be instructed that meticulous oral hygiene is vital to reduce the chance of escalation of symptoms or infection during this time. The mouth should be cleansed at least every four hours and at bedtime.¹⁰ A 10% carbamide peroxide solution, a proven oral debriding agent and wound cleanser can be effective at killing germs and deep-cleaning gingival areas. Patients should rinse with the solution for one minute per treatment to help remove unhealthy tissue and soothe inflammation.

Some treatment options for xerostomia overlap with those for mucositis; in both cases, use of mouthrinses and strict hygiene are encouraged to keep the tissues clean and moist. (Emphasize, however, that only alcohol-free mouthrinses should be used.¹¹) Palliative treatments specific to xerostomia include sucking on ice chips or sipping water frequently, use of a humidifier in the home, and use of saliva substitutes.¹² Patients may also enjoy sugar-free gum or candy.¹³

Talk with your patients about their daily routines, and use what you learn to make customized suggestions. Some patients, for instance, may like to wear fluoride trays in the shower. Active patients may have an easier time using pocket-sized treatment products they can carry with them throughout the day. Patients who have mobility problems may appreciate your recommendation of a pharmacy with a mail order and automatic refill program. Hygienists can be very effective in helping patients recognize the importance and achievability of maintaining oral health.

Many cancer patients meet with a long list of health professionals during their treatment. Our advice as hygienists, however, can stand out if we take the time to listen to patients’ concerns and help them create a customized plan of action. Rather than feeling overwhelmed, our patients can feel they are playing an important role in maintaining their quality of life and working toward wellness.