Nutrition During Cancer Care
Oncologists and other care providers who include the mouth as part of their routine examinations can identify normal and abnormal and refer for the care of problems before they become big concerns. A great deal of information can be obtained, and with potential for oral side effects of cancer therapy or potential intraoral recurrences, a quality intraoral exam should be performed at every oncology follow-up visit. As advocated by the Hartford Foundation, it is time to change HEENT to HEENOT and always include an oral exam!
Before performing an oral exam, have a sequence of what to look at and what is normal. Knowing what is normal makes it possible to be alerted to what is abnormal. The following sequence is intended to assure non-dental providers are fully comfortable examining oral tissues. Doing it the same way each time helps include key points.
1. Face and Neck
Look for bilateral symmetry. Identify any lumps, swelling, sores, moles that won’t heal or have grown larger, and any ulcers or painful areas.
Should be smooth and free from swellings, lumps, or sores. There should be symmetry, and the vermillion border separating the lip and skin should be a smooth line.
3. Inside the lips and cheeks
Should be smooth, pink, and moist. Should be free from ulcers and sores.
Inside upper lip
Inside lower lip
Cheek- buccal mucosa
4. Roof of Mouth
Should be free from swellings, lumps, or ulceration. Ridges behind front teeth are called rugae and are normal provided they are symmetrical.
Edentulous palate with inflammation
Pull tongue out with gauze to see sides, top, and bottom.
Ventral surface and frenum
6. Floor of Mouth:
Should be symmetrical, smooth, pink, and moist.
7. Gums (gingiva):
Should be pink, stippled like orange peel, and come to a point between teeth.
Ethnic pigmentation is normal
For more information about the oral examination, see these resources:
Smiles for Life Oral Health Curriculum- The Oral Examination
Oral Health Nursing Education and Practice (OHNEP) promotes including oral exams as part of the head and neck exam HEENOT
Examination of the Mouth (CDC, 1967) on YouTube
DoctOral: Mobile app for healthcare professionals - Dott. Olga Di Fede and Prof. Guiseppina Campisi
You may also wish to learn about:
More information regarding the following topics will be coming soon:
Importance of good oral health before, during, and after cancer care
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The information on the Rhode Island Cancer and Oral Health Resource Guide, including but not limited to, text, graphics, images, and other external materials are for informational purposes only. The Partnership to Reduce Cancer in Rhode Island does not provide medical advice. The information on this website is not intended as a substitute for professional medical advice, diagnosis, or treatment.