To mark the Oral Health Foundation’s Mouth Cancer Action Month, we hear from Joss Harding, an award winning dental hygienist from Stroud, Gloucestershire, and clinical ambassador for the Mouth Cancer Foundation, whose passion is caring for the oral health of patients with cancer.
There are over 8,700 cases of oral cancer diagnosed in the UK each year, and over 2700 lives are lost to the disease (Mouth Cancer Foundation | Helpline: 01924 950 950.)
The main reason for this is a lack of public awareness of the risks, signs and symptoms, leading to late detection – which can be fatal. According to the Oral Health Foundation, a 45-second self check could save a life.
That’s why November is Mouth Cancer Action Month, featuring a range of activities and resources to raise public awareness of oral cancer and the importance of regular checks, both at home and in the dental surgery.
Joss Harding is a dental hygienist based in Stroud, Gloucestershire, who has a special interest in caring for patients suffering from cancer, and in particular cancers of the head and neck, including mouth cancer.
She is a Clinical Ambassador for the Mouth Cancer Foundation, and has written information and guidance for both patients and professionals. She has been involved in the production of Public Health England’s national guidelines on oral cancer early diagnosis and prevention.
‘My interest in dental care for patients with cancer started in the 1990s, when I had a new patient who had had surgery and radiotherapy, and I didn’t know how to help them,’ said Joss.
Finding that very little information was available, and that most professionals also knew very little about the problem, she was ‘obstinate, and started asking questions’.
Her knowledge and expertise has grown over the years, and she’s still learning and sharing her knowledge. She’d really like to develop an online module for training dental and maxillofacial professionals.
Listen
Listening to what patients tell you is key, she says, especially with male patients who may not be naturally talkative, and particularly when they are feeling low.
‘It’s easy to get it wrong, she warned. ‘You think you can help them but it’s their journey, and sometimes you just need to listen and signpost them.’
‘When patients receive a diagnosis, the anxiety it causes means that mouth care will probably go out of the window,’ she said.
Aside from the cancer itself, they will be facing a huge variety of challenges to their oral health – possibly including pre-existing problems such as decay, gum disease, dry mouth, halitosis and poor diet.
‘If dental health is not on their radar beforehand, it will not be on it after diagnosis.’ More important to them at the time might be financial worries, concerns for their family and so on.
Extremely personal
Realising that for some patients nothing will be the same again is devastating, and the suicide risk for people with head and neck cancers cannot be ignored, she warned.
Dry mouth is a particular problem for patients undergoing treatment; with chemotherapy this is usually resolved after two to four weeks.
But after radiotherapy a high percentage of patients will suffer from dry mouth for the rest of their lives. This is not only painful and unpleasant, but the lack of saliva also increases the risk of dental disease.
Different products suit different patients and the response to treatment can be extremely personal.
Joss likes to give her patients a goody bag to take home and try. ‘It makes them feel cared for, it gives them options, and I ask them to check with their oncologist that they are happy for them to use these products,’ she said. ‘It’s all about collaborating with the other team members who are working with these patients.’
She gives her patients gentle reminders about their oral health before treatment if possible and, although she can’t usually see them during their treatment, she has sometimes been in touch with the ward staff and other professionals to offer advice, and to help look after them.
‘We need more inter-professional talk going on,’ she stressed.
Biomin F – ideal for cancer patients
Because they are often taking multiple medications, with resultant dry mouth, cancer patients are particularly at risk of demineralisation and dental decay.
Biomin F has been clinically proven to be more effective than regular toothpastes at replenishing lost or damaged tooth enamel, and so is an ideal choice for patients undergoing treatment. ‘
I’ve been offering it to my cancer patients with good results,’ said Joss. ‘The inclusion of calcium and phosphate together with fluoride is attractive. But also the slow release concept of Biomin, as well as the low abrasivity of the paste.’
Her patients tell her that they appreciate the fact that Biomin continues to protect their teeth all day long, not just immediately after brushing.
Symptoms of mouth cancer
- An ulcer or white or red patch anywhere in the mouth that does not heal within three weeks
- A lump or swelling anywhere in the mouth, jaw or neck that persists for more than three weeks
- Difficulty swallowing, chewing or moving the jaw or tongue
- Numbness of tongue or other area of the mouth
- A feeling that something is caught in the throat
- A chronic sore throat or hoarseness that persists more than six weeks
- Unexplained loosening of teeth.
Want samples or a practice visit? Speak to our UK Dealers, Trycare on 01274 88 55 44 or [email protected] or CTS on 01737 765 400 or [email protected].
Good evidence base
The mild minty flavour of Biomin is also pleasant for patients undergoing chemotherapy who may not be able to tolerate strong tastes.
Ethical issues are important when recommending products to patients on cancer treatment, or recovering – many of them become much more interested in such things – and Biomin F fits well with that.
Not only does it help them with sensitivity, it also works to remineralise lost and damaged tooth enamel – in a way that is not harmful to the environment.
‘It’s nice to be able to offer something that’s not tested on animals, contains no animal products and has a good evidence base,’ said Joss. ‘I love Biomin, it’s a lovely option to offer.’
Her local area, Stroud, has a high proportion of people who care about the environment, and choose organic and similar options.
She welcomes the alternative of Biomin C for those patients who don’t want fluoride.
Reduce sensitivity
‘It’s nice to be able to point them to a good and effective option,’ she added. Patients who are eating a lot of fruit or drinking squash or fruit juice, understand the science of Biomin when she explains it.
‘They really enjoy using it and notice a reduction in their sensitivity, which is perfect.’
‘I don’t battle with patients over their oral hygiene while they are undergoing treatment,’ said Joss. ‘It is often way down their priority list. They do come back afterwards, and often they have a different outlook.
‘When they are going through cancer treatment, I say to them: eat and drink everything, and we will look after your teeth.
‘When you come back to me, we will help you out and get you back on the right road. Our role is to guide them – and if they don’t want to listen, that’s fine too.’
*Wednesday November 16 is Blue Wednesday, when the Oral Health Foundation is asking you to share a very simple message: A self check for mouth cancer takes 45 seconds and can save your life.
Full details, resources etc are on their website: www.dentalhealth.org/bluewednesday
Joss has an information website: www.mouthcareforcancerpatients.co.uk
She is hosting a charity fundraising conference for dental and medical professionals entitled: ‘Talking Mouths Talking Cancer Care’ on Saturday 3 June 2023 in Manchester.
For details contact Joss on [email protected],
