New patient baseline assessment
• Nurses to screen for oral mucositis and associated oral complications. Once detected,
assess at each patient visit
• Provide verbal and written information on maintaining oral hygiene at onset of treatment
• Maintaining oral health throughout the treatment phase is necessary to:
- maintain adequate hydration and nutrition
- reduce the incidence, severity and duration of oral mucositis - prevent or minimize the effects of oral complications
• A dental exam and any interventions should be performed by a dentist (or oral oncology specialist) as early as possible before starting radiation or chemotherapy.
Flossing
• Floss at least once daily • Do not floss if:
- Platelet count below 50, 000 mm3 or unless otherwise advised by physician
NOTE: Do not initiate flossing with cancer treatment if it is not part of your regular routine unless recommended by a dentist.
Brushing
• Use small, extra soft nylon bristled tooth brush
- To soften bristles, rinse toothbrush under warm water for about 30 seconds
• Use non-abrasive, fluoride toothpaste with a neutral taste- flavoring agents may irritate gums
• Brush two to four times daily
- Brush all tooth surfaces using a short circular motion or horizontal strokes
- Brush tongue back to front
• Rinse toothbrush well after each use; allow to air dry
• Replace toothbrush when bristles are no longer standing up straight Oral Rinses
• Oral rinses help keep mouth moist and clean by removing debris
• Frequency and Use:
- After brushing, rinse mouth a minimum of four times daily
- Use 1 tablespoon (15 ml) of oral rinse, swish in oral cavity for 30 seconds, then spit out - Prepare mouth rinse solution daily to avoid risk of contamination
- Causes pain or bleeding gums which does not stop after 2 minutes