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Oral Cancer Pt Management (Tx Modalities and Side effects (Surgery (Short…

- - - - Dysphagia
        
        Difficulty swallowing/limited mouth opening
        
        Speech issues
        
        Anaesthesia
        
        Parasthesia (mouth/face)
    - - Tissue loss + Bone loss
        
        Functional problems
        
        Cosmetic concerns
        
        Dysphagia and speech issues
  - - - mucositis
        
        stomatitis
        
        xerostomia
        
        Oral infections
        
        altered taste
        
        Pain
        
        nausea/vomitting
        
        systemic/organ involvement
    - - Tissue loss/bone loss (MRONJ)
        
        Increased risk of perio and caries
        
        bone marrow/immuno-suppression (infection risk)
  - - - Mucositis (50% cases)
        
        altered taste
        
        hyposalivation
        
        Oral infections
        
        (bacterial/fungal/viral/muscoal lesions)
        
        Trismus
    - - Xerostomia (60% LT)
        
        Increased risk of perioontal disease and caries
        
        Subcutaneous fibrosis
        
        ORNJ
        
        Telangiectasia
- - - - Check for Oral Cancer Recurrence
        
        Frequent periodontal management
        
        Reinforce OH
        
        adapt oral-self care if limited opening and access
  - - - Check for OSCC recurrence or second primary
        
        monitor WBC and platelet levels
        
        Monitor and manage mucositis
        
        Manage perio condition
        
        Reinforce OHI compliance
    - - monitor platelets and WBC levels
        
        reinforce OHI compliance
  - - - Educate/Stress OHI - Regular follow-ups
        
        Treat the existing periodontal/dental condition
        
        Extractions non-restorable teeth
    - - Check for recurrence of cancer/lesions
        
        Monitor for ORNJ
        
        Manage radiation caries, perio disease
        
        Manage mucositis
        
        Manage Hyposalivation
        
        Provide dietary counselling and reinforce OHI
      - Mucositis =
        Analgesic mouthrinse (2% lidocaine)
        Topical creams (Orobase - 0.5% triamcinolone)
        Folic acid + tx secondar infections
      - Xerostomia
        = Frequent watersips (q10mins), artifical saliva spray, mouth moisturizer (GC Dry Mouth), Salivary stimulant tablets, pilocarpine 2%
      - ORNJ Prevention
        = (i) CHX rinse, 1 week follow + up
        (ii) pre-Op ab + CHX +1/2 week follow up
        (iii) pre-Op ab + CHX rinse + postop ab 1wk +1/2 week follow up
        ORNJ Management
        = (i) CHX rinse, OHI, review
        (ii) Gentle debridement, systemic ab/analgesics, CHX, OHI and review
        (iii) Surgical debridement, ab therapy, analgesics, CHX, OHI and review