Thyroid Cancer
Mock Case Study
Name: Jessica
Age: 32
Gender: Female
Race: Mexican-American
Physical Assessment: Patient appears to be very stressed and complains of being tired
Mental Assessment: Has been depressed since her recent diagnosis
Social Assesment: Married with two children, and a full time student
Medical Assessment: Physcian found a large lump in the right lobe of her thyroid during a routine exam. Patient was unaware of any problems.
Dental History: Extracted #1, #16, #17, #32
MOD composite #3, #15, #18, #31
Root canal #4, #8
FMX- taken 1 year ago
E/O - I/O Assessment: Extra oral- hard mass the size of a quarter on right side of thyroid
Intra oral- no significant findings
Communication To Patient: There may be side effects from your future radiation treatment. Some side effects that you could experience are dry mouth, cavities, loss of taste, sore mouth and gums, infections, and jaw stiffness. We want to make sure your mouth is healthy before you start radiation treatments. This may reduce your chances of having side effects from radiation. Once your treatment has started it is important to look in your mouth everyday for sores or other changes. It is important to keep your mouth moist ( drink lots of water, sugarless gum, saliva substitute). Brush your teeth 30 minutes after every meal and at bedtime ( soft bristle brush, toothpaste with fluoride, avoid mouthwashes with alcohol). Floss your teeth everday. Remember to stay away from sugary foods and fermentable carbohydrates that increase your chances of getting cavities. The dentist may also prescribe a fluoride gel that can help prevent cavities. You can prevent and treat jaw stiffness by exercising your jaw muscles (Open and close the mouth as far as possible 20 times without causing pain. Repeat 3 times per day). Please feel free to call the office anytime during your radiation treatment if you have any questions or problems.
Appointment Planning: Schedule an appointment 1 month before first radiation treatment
Client Positioning: Keep patient comfortable
DH Procedures: Check and clean teeth, take x-rays if needed
Safety Precautions: Use lead apron with thyroid collar when taking x-rays
OHI: Demonstrate Stillman's toothbrushing method. Indicated for sensitive gingiva which may be a side effect of the radiation treatment.
Personal Reflection: I chose thyroid cancer as a topic because I had a close friend diagnosed with it two years ago. I was shocked when I found out the news that she had cancer at the age of 32. I had never personally known anyone that had cancer at such a young age. I have always wanted to learn more about the disease.
Additional Information: Radiation exposure does increase risk of thyroid cancer, and the risk increases with the amount of radiation exposure. The developing thyroid is especially susceptible to radiation. Children exposed to radiation are at increased risk of developing thyroid cancer later in life. The thyroid can absorb radiation through ingestion of radioactive material, especially radioactive iodine, or through external exposure such as from an X-ray machine. Dental X-rays give a very low dose of radiation to the mouth. There is some scatter of radiation and the potential for some radiation absorption by the nearby thyroid and other organs. The American Dental Association notes that a leaded apron placed over the torso minimizes radiation exposure to the chest and abdomen and should be used when any dental X-ray is taken. The group also notes that a leaded thyroid collar can protect the thyroid from radiation and should be used whenever possible. ( Information provided by Dr. Otis Brawley Chief Medical Officer, American Cancer Society).
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Age: 32
Gender: Female
Race: Mexican-American
Physical Assessment: Patient appears to be very stressed and complains of being tired
Mental Assessment: Has been depressed since her recent diagnosis
Social Assesment: Married with two children, and a full time student
Medical Assessment: Physcian found a large lump in the right lobe of her thyroid during a routine exam. Patient was unaware of any problems.
Dental History: Extracted #1, #16, #17, #32
MOD composite #3, #15, #18, #31
Root canal #4, #8
FMX- taken 1 year ago
E/O - I/O Assessment: Extra oral- hard mass the size of a quarter on right side of thyroid
Intra oral- no significant findings
Communication To Patient: There may be side effects from your future radiation treatment. Some side effects that you could experience are dry mouth, cavities, loss of taste, sore mouth and gums, infections, and jaw stiffness. We want to make sure your mouth is healthy before you start radiation treatments. This may reduce your chances of having side effects from radiation. Once your treatment has started it is important to look in your mouth everyday for sores or other changes. It is important to keep your mouth moist ( drink lots of water, sugarless gum, saliva substitute). Brush your teeth 30 minutes after every meal and at bedtime ( soft bristle brush, toothpaste with fluoride, avoid mouthwashes with alcohol). Floss your teeth everday. Remember to stay away from sugary foods and fermentable carbohydrates that increase your chances of getting cavities. The dentist may also prescribe a fluoride gel that can help prevent cavities. You can prevent and treat jaw stiffness by exercising your jaw muscles (Open and close the mouth as far as possible 20 times without causing pain. Repeat 3 times per day). Please feel free to call the office anytime during your radiation treatment if you have any questions or problems.
Appointment Planning: Schedule an appointment 1 month before first radiation treatment
Client Positioning: Keep patient comfortable
DH Procedures: Check and clean teeth, take x-rays if needed
Safety Precautions: Use lead apron with thyroid collar when taking x-rays
OHI: Demonstrate Stillman's toothbrushing method. Indicated for sensitive gingiva which may be a side effect of the radiation treatment.
Personal Reflection: I chose thyroid cancer as a topic because I had a close friend diagnosed with it two years ago. I was shocked when I found out the news that she had cancer at the age of 32. I had never personally known anyone that had cancer at such a young age. I have always wanted to learn more about the disease.
Additional Information: Radiation exposure does increase risk of thyroid cancer, and the risk increases with the amount of radiation exposure. The developing thyroid is especially susceptible to radiation. Children exposed to radiation are at increased risk of developing thyroid cancer later in life. The thyroid can absorb radiation through ingestion of radioactive material, especially radioactive iodine, or through external exposure such as from an X-ray machine. Dental X-rays give a very low dose of radiation to the mouth. There is some scatter of radiation and the potential for some radiation absorption by the nearby thyroid and other organs. The American Dental Association notes that a leaded apron placed over the torso minimizes radiation exposure to the chest and abdomen and should be used when any dental X-ray is taken. The group also notes that a leaded thyroid collar can protect the thyroid from radiation and should be used whenever possible. ( Information provided by Dr. Otis Brawley Chief Medical Officer, American Cancer Society).
Image provided by google