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Current practice and knowledge of oral care for cancer patients: a survey of supportive health care providers

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Abstract

Background

The Oral Care Study Section of the Multinational Association of Supportive Care in Cancer (MASCC) and the International Society for Oral Oncology (ISOO) conducted a survey on clinical practices of oral/dental management of cancer patients among supportive health care providers. The main purpose was to evaluate the knowledge and current practice for preventing and managing oral side effects associated with intensive chemotherapy (ICT), hematopoietic cell transplant (HCT), and radiation therapy to the head and neck (H&N RT).

Materials and methods

A questionnaire designed and pretested was sent to 212 MASCC/ISOO members around the world with different dental and medical backgrounds.

Main results

Seventy-four individuals (35%) responded. The majority of respondents were aware of possible oral complications and provided patients with clinical strategies and recommendations although there was considerable variability among the respondents. Approximately 75% stated that patients were referred for oral/dental care prior to H&N RT and ICT including HCT. However, integrated dental and medical services were reported available in only about 25% of the institutions, and most patients were referred to community-based dental professionals.

Main conclusions

The survey represents a first review of current, international oral care practices. It suggests a need to develop evidence-based clinical guidelines to support effective oral/dental interventions and management strategies for this population. Furthermore, strategies for implementation of oral care protocols and better integration of dental and medical services should be developed. Caution in interpreting these findings is urged due to the limited response rate.

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Acknowledgements

We would like to thank Ms. Terra Patterson, University of Missouri-Kansas City student assistant, for her conscientious assistance with data management.

Author information

Authors and Affiliations

  1. Department of Dental Public Health and Behavioral Science School of Dentistry, University of Missouri Kansas City, 650 E 25th Street, Kansas City, MO, 64108, USA

    Gerry J. Barker & Karen B. Williams

  2. Department of Oral Medicine and Diagnostic Sciences, Chicago Cancer Center, University of Illinois, Chicago, IL, USA

    Joel B. Epstein

  3. Department of Oral Medicine, Tel Aviv University, Tel Aviv, Israel

    Meir Gorsky

  4. Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands

    Judith E. Raber-Durlacher

  5. Department of Periodontology Academic Centre for Dentistry, Amsterdam, The Netherlands

    Judith E. Raber-Durlacher

Authors
  1. Gerry J. Barker
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  2. Joel B. Epstein
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  3. Karen B. Williams
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  4. Meir Gorsky
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  5. Judith E. Raber-Durlacher
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Corresponding author

Correspondence to Gerry J. Barker.

Additional information

For the Oral Care Study Section of the Multinational Association of Supportive Care in Cancer and the International Society for Oral Oncology. Chairs: Dr. Fred K. L. Spijkervet and Dr. Philip C. Fox.

Appendix

Appendix

Summary of oral care survey

  1. 1.

    When are oncology patients at your institution or affiliated cancer programs referred for medically necessary oral–dental treatment?

  2. 2.

    Are oncology patients referred for dental prophylaxis (cleaning)?

  3. 3.

    Are oncology patients at your institution or affiliated cancer programs asked if they have a history of herpes simplex viral infection?

  4. 4.

    Is a standardized oral assessment tool used for oncology patients?

  5. 5.

    If a patient needs teeth extracted prior or during myelosuppressive chemotherapy, how many days of healing do you prefer prior to neutropenia?

  6. 6.

    If a patient needs teeth extracted prior to radiation therapy to the head and neck, how many days of healing do you prefer prior to the start of radiation therapy?

  7. 7.

    If a patient has a central venous catheter is antibiotic prophylaxis recommended prior to invasive dental procedures?

  8. 8.

    Are oncology patients specifically instructed to brush his/her teeth?

  9. 9.

    Is a different type of toothbrush or tooth-cleansing aid recommended during periods of neutropenia?

  10. 10.

    Is the use of dental floss or an interdental cleaning aid recommended during chemotherapy?

  11. 11.

    Is a mouthwash or mouth rinse recommended during chemotherapy?

  12. 12.

    Is a mouthwash or mouth rinse recommended during radiation therapy to the head and neck?

  13. 13.

    What protocol is recommended for patients with dentures?

  14. 14.

    Are preventive-palliative measurements recommended for patients with dry mouth?

  15. 15.

    Are palliative measures recommended for dry lips?

  16. 16.

    Is a fluoride rinse or gel recommended for chemotherapy patients with dry mouth?

  17. 17.

    Is a fluoride rinse or gel recommended for patients undergoing radiation therapy to the salivary glands?

  18. 18.

    Are custom gel carriers recommended for fluoride application for patients undergoing radiation therapy to the salivary glands?

  19. 19.

    Are other measures recommended to prevent radiation caries/demineralization?

  20. 20.

    Are palliative measures/medications recommended for oral pain related to mucositis?

  21. 21.

    Is a standardized mucositis scoring system/scale used to measure mucositis?

  22. 22.

    Is a standardized pain scale used to measure pain related mucositis?

  23. 23.

    Are sugary/high-carbohydrate snacks restricted between meals during cancer therapy?

  24. 24.

    Are soda pops and highly sugared beverages restricted during cancer treatment?

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Barker, G.J., Epstein, J.B., Williams, K.B. et al. Current practice and knowledge of oral care for cancer patients: a survey of supportive health care providers. Support Care Cancer 13, 32–41 (2005). https://doi.org/10.1007/s00520-004-0691-5

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  • DOI: https://doi.org/10.1007/s00520-004-0691-5

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