Bringing Oral Health to the Frontlines of Cancer Care
According to Global Burden of Disease data, cancer accounts for approximately 10 million deaths annually, representing roughly one in six global deaths.1 As the incidence of cancer increases, so too are the cancer therapeutics that directly impact the oral cavity.2 Dental complications can arise while a patient is undergoing cancer treatment, resulting in long-lasting effects years after treatment is complete.
Adverse side effects to cancer treatment include oral mucositis, xerostomia, osteonecrosis, acute periodontal disease, Candida infections, herpes simplex viral infections, and trismus. Approximately 40% of patients develop some form of oral mucositis.3 This percentage rises to 60% to 85% for patients undergoing hematopoietic stem cell transplantation and to almost 90% for patients treated with radiation plus chemotherapy for head and neck cancer.3 Oral complications can significantly affect patients’ quality of life, increase their financial burden, and delay cancer treatment. However, far too often, other medical concerns overshadow the oral assessment and management.2
Lack of Knowledge Among Medical Providers
Despite a high incidence of oral complications, most oncology patients are not educated on the importance of oral health throughout the course of their cancer treatment. Promoting oral health during cancer treatment is critical to improve patients’ quality of life. This requires increased awareness, prevention, and treatment by multidisciplinary care teams, including dental hygienists.2 Traditionally, nurses are the frontline providers in patient management. Unfortunately, nurses and other medical professionals do not receive much education on oral health.
The oral cavity is a recognized source of inflammation, yet approximately 70% of medical school curricula only include 5 hours or less of oral health content and 10% do not have any education or training in oral health.4 In a systematic review on nurses’ knowledge, attitudes, and practices regarding oral healthcare in cancer patients, studies found that nurses significantly vary in their understanding of oral diagnosis, treatment, and hygiene protocols.5 While some nurses may be aware of the potential oral complications, many lack the knowledge and/or confidence to assess and treat oral complications. Several studies indicated that nurses struggled to identify and treat xerostomia, dysphagia, and trismus. Deficiencies in the referral process and care coordination between healthcare and oral health professionals were also highlighted, emphasizing the need of standardized protocols, comprehensive assessments, and early intervention strategies.5
* References and figures can be found in the original article via the link above.
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