KIM MILLER, RDH, BSDH, is the co-founder of
PerioFrogz.com, an information-based website
providing free current oral-systemic research
summaries and patient education downloads.
Kim is also a coach with Inspired Hygiene,
delivering customized hands-on training. She
speaks internationally, writes articles and webinars, and enjoys clinical dental hygiene. Kim
lives in Arizona and welcomes you to contact
her at firstname.lastname@example.org.
In the past six months within my circle of clients, colleagues,
family, and friends, there have been two confirmed diagnosis of thyroid cancer. Both cases were detected with an external head and neck exam — one provided by a dentist and
the other by a hygienist.
Most patients diagnosed with head and neck cancer will
end up receiving some type of chemo or radiation therapy.
These treatments, while an important part of treating the
cancer, can bring on a painful and debilitating condition
called oral mucositis (OM) or stomatitis.
OM is characterized by red, shiny, and/or swollen oral
tissues. Ulcerations on the tongue and gums are common.
Difficulty swallowing or talking, general dryness, mild
burning, or pain when eating can also occur. In severe cases,
the condition is called confluent mucositis, and the mucus
membrane of the patient’s entire mouth and tongue can be
coated by white mucus that is up to 1 mm thick.
OM impacts over 400,000 cancer patients. More than
40% of all patients undergoing conventional chemotherapy
and 97% to 100% of patients undergoing conventional radiation or bone marrow transplant therapy are affected. OM
generally begins five to 10 days following the initiation of
chemotherapy or radiation therapy, lasting anywhere from
one week to six weeks or more. 1, 2, 3
TREATING ORAL MUCOSITIS
I’d like to introduce you to a product designed to maintain
and heal the oral mucosa called NeutraSal by Invado Pharmaceuticals.
NeutraSal comes in single-use packets of dissolving pow-
der, which, when mixed with water, creates an oral rinse su-
persaturated with calcium and phosphate ions. These ions
diffuse into the intercellular spaces in the epithelium and
permeate the mucosal lesions in mucositis. The advanced
electrolyte solution mimics natural saliva and helps to re-
store the normal ionic and pH balance in the oral cavity aid-
ing healing in the following ways:
cess, the blood clotting cascade, and tissue repair
accumulation of mucus, and discourages the colonization
When NeutraSal is used at the start of chemotherapy
or radiation therapy, it can help maintain the correct oral
environment and initiate healing of the oral mucosa. Neu-
traSal has also been shown to be effective in the treatment
of Sjögren’s syndrome and the resulting xerostomia. 1, 2, 3
NeutraSal is available by prescription. I appreciate that
there is a direct access program that provides products for
all patients experiencing oral mucositis or xerostomia who
require NeutraSal treatment, regardless of their insurance
or financial situation. With each prescription, the patient is
shipped either the complementary Sjögren’s support kit or
the oral mucositis support kit.
Please visit the NeutraSal website, www.neutrasal.com,
for patient testimonials, clinical trials, and research, as well
as information on how to order and prescribe NeutraSal.
NeutraSal does not contain sugar, yeast, wheat, gluten, soy,
milk, egg, shellfish, or any preservatives.
TAKE A PROACTIVE ROLE
With the incidence of head and neck cancers still rising,
the importance of external head and neck exams cannot be
overstated. Despite the fact that we all learned how to do
these exams in school, I find that very few hygienists and
dentists are actually providing a comprehensive head and
neck exam. This exam includes palpating the following:
- Anterior and posterior temporalis
- Pre- and retro auricular (in front and behind ears)
- Facial lymph nodes (under cheek bones)
- Submandibular/submental lymph nodes (under chin)
- Supraclavicular/anterior scalene lymph nodes (collar
continued on pg. 104
B Y KIM MILLER, RDH, BSDH