| From
the Pharmacy's Desk
ORAL CARE BEFORE, DURING AND AFTER COMPLETION
OF RADIOTHERAPY
By Ng Hui Cheng, Oncology Pharmacist, NCC
The
mucous lining of our mouth and gut is often a prime target for treatment-related
toxicity by virtue of its fast cell turnover rate. The estimated
frequency of oral complications as a result of head and neck radiotherapy
to areas involving the oral cavity is close to 100%!
The
most common oral complications include swelling of the mouth lining
(mucositis), decreased saliva production, loss of taste, pain and
difficulty in swallowing. These are not only uncomfortable but can
also lead to dehydration, malnutrition and infection. More so, due
to decreased saliva production, the mouth may feel dry and sore
with thick, sticky saliva causing discomfort when chewing or swallowing.
This may also cause decline in dental hygiene and health.
Such
symptoms usually occur during the second or third week of radiotherapy.
Though they are common, most are temporary. They gradually subside
within two to three weeks after completion of treatment. The severity
of the symptoms depends on the type of radiation, total dose received,
and extent of treatment. Observe closely for these symptoms and
report them to your doctors, nurses or pharmacists immediately so
that they can be treated early.
Oral
care before starting radiotherapy: |
Oral
care during and after radiotherapy: |
| As
a preventive measure:
1. Routine oral hygiene practice
- Tooth
brushing
- Soft nylon bristled brush is preferred
- Brush
2 to 3 times daily
- Flossing
- Once daily
2.
Dental examination at least 1 month before starting radiotherapy
to allow ample time for healing from any dental procedures.
|
1.
Routine oral hygiene practice as above (Foam toothbrush may
be used if the use of regular toothbrush is not possible)
2.
On a constant look out for mouth soreness, oral ulcers, and
signs of infection (white patches) so that treatment can be
started early.
3.
Bland rinse
- Varieties:-
Normal saline 0.9%*
- #Sodium bicarbonate solution
- Normal saline plus sodium bicarbonate solution
-
Repeat rinsing every 2 to 4 hours or as required for pain
|
*
Normal saline solution is prepared by adding approximately
1 teaspoonful of table salt to a glass of water. The solution
may be at room or refrigerated temperatures depending on patient’s
preference. It enhances oral lubrication and stimulates the
salivary glands to increase production of saliva.
# Sodium bicarbonate solution is prepared by adding approximately
1 to 2 tablespoonfuls of sodium bicarbonate powder to a glass
of water. It can be used when thick viscous saliva is present. |
|
