Mr. Glenn Maxwell is a 40-year-old male diagnosed with Oral Squamous Cell Carcinoma (OSCC), which has affected the floor of his mouth. With this condition, several personal challenges affect his daily life, and thus, there is a need to consider a well-thought-out dental care plan for self-management. Consequently, the patient’s chemotherapy for cancer management has resulted in side effects such as bleeding during brushing, flossing, and dry mouth effects. Additional side effects from this treatment are altered taste, which must be addressed in the patient. While addressing these concerns, it is critical to understand that Mr. Glenn is a diabetic type 2 patient possessing high cholesterol levels and thus needs a comprehensive focus to handle systemic health and oral health concerns. The following is a care plan for the patient’s condition.
Overview of the care plan
Oral self-care interventions.
Under toothbrush use, I recommend using a brush with soft bristles and a small head to reduce complications encountered during brushing. The most recommended model is a powered brush for removing plaque. On the other hand, interdental care will entail using a soft, flexible, and interdental brush to clean the teeth gently. This brush will help address the patient’s bleeding concerns as it promotes comfort. The third recommendation is on flossing issues faced by the patient. Under this concern, I recommended applying a modified bass technique attached to the power brush to ensure reduced trauma and effectiveness in plaque removal.
The recommended toothpaste for this patient is any brand with fluoride and limited flavors, as it will promote patient compliance. Fluoride is preferred because of its cariostatic properties of managing the dry mouth effects. Oral rinsing concerns are best attained in this patient using an alcohol-free rinse to manage possible skin infections. Additionally, the rinse should work to address the patient’s taste concerns. The last recommendation is on care products for interdental. Generally, I recommend using silicone-tipped brushes for increased interdental management. This recommendation is based on Mr. Glenn’s dry mouth effects and altered taste issues.
Rationale for recommendations and goals
Given the patient’s existing issues and management concerns, Mr. Glenn’s primary dental goals are to lower the risk of infection, facilitate competent oral health, and improve patient comfort while brushing or eating. Additionally, the goals in this section entail promoting quality of life while managing oral hygiene and diabetic conditions (ADA Council on Scientific Affairs, 2018).
Managing bleeding during brushing and flossing
The interventions to attain this goal are using modified bass techniques whereby the patient should use a soft-bristled brush to address the interdental concerns. The rationale for this intervention is to bring in effective plaque removal and manage the traumatic impact on the delicate tissues, thus lowering the risk of patient bleeding.
Controlling dry mouth effects
Intervention for managing the dry mouth effects is choosing toothpaste with fluoride, applying an alcohol-free rinse, and bringing in other interdental care products to support the patient. This intervention’s rationale for attaining the outlined goal is the product’s oral rehydration abilities and fluoride delivery for microbial control. By considering the two issues, the patient can manage discomfort concerns and reduce the chances of dry-mouth effects.
Bringing back taste
Interventions to this goal include using mild-flavored toothpaste with additional concern, including silicone at the tip of the brush rubbing on interdental sections. The rationale for this intervention is to reduce the use of intense flavors while bringing in interdental management to help improve taste and lower the side effects of chemotherapy treatment taken in the past.
Methods for individual oral self-care
In brushing techniques, I recommend that the patient use a moist toothbrush with a pea-sized drop of toothpaste. Secondly, the patient should prioritize holding the brush bristles at 45 degrees to the gum line, using minimal force to hold and move the brush, and using back-and-forth motions while cleaning the teeth. I recommend flossing techniques to the patient, including breaking about 18 inches of floss, wrapping floss on the middle finger while leaving two inches of floss at the hands, and inserting floss between the teeth with up and downward movements. Additionally, I recommend that the patient curve floss around the mouth using a C-shaped form and gentle movement in the gum line. Repeated steps in floss movements are essential for addressing the floss concern if the patient effectively adopts them.
The function of dental hygienist
Given Mr. Glenn’s condition, the dental hygienist must provide constant patient education and support to manage the underlying conditions. This is because the patient requires regular monitoring that plays a role in assessing oral health and adaptability to the care plan, which can only be effective if applied under a specialized dentist (Leung et al., 2018). Secondly, the dentist offers coordination roles between the patient and oncologist, which are critical for improved patient health and experience in the treatment intervention for the two existing conditions. While meeting the outlined roles, it is essential to ensure that the hygienist works in collaboration with the patient locality and accepts possible realities in attaining the hygiene goals while at the same time meeting the psychological aspects linked to the initial cancer diagnosis.
Motivation and techniques to attain behavior change
Based on the prescribed conditions, there is a need to develop an in-depth understanding of the patient to recommend the best intervention measures (American et al., 2022) as such motivational interviews will be organized to explore and understand Mr. Glenn’s beliefs, attitudes, and limitations that may impact the oral self-care plan. Thus, I will consider forming a collaborative association with the patient to ensure that his practices align with the proposed care plan and that the management recommendations are included.
Also, I will consider the evaluation of patient’s preferences and promoting long-term compliance with the best practices. Other inputs to attain this condition include promoting positive reinforcement while outlining simple achievements made by the patient to meet the required goals. In the same way, there is a need to address the emotional issues resulting from diabetes and cancer management practices that will eventually translate to overall individual behavior change and adoption of the best practices to promote good health and cope with the new condition affecting the health of the patient (National Institute of Dental and Craniofacial Research, 2020). This motivation aims to help Mr. Glenn develop specific, measurable, achievable, and relevant goals that can be achieved within the provided timelines for patient condition management. Additionally, this move will help ensure that the client is motivated towards a positive living while managing the existing medical conditions and employing the most relevant personal management measures.
References
ADA Council on Scientific Affairs. (2018). Powered Toothbrushes: An Evidence-Based Review. Journal of the American Dental Association, 149(1), 25-35.
American Cancer Society. (2022). Oral Cavity and Oropharyngeal Cancer. Retrieved from https://www.cancer.org
National Institute of Dental and Craniofacial Research. (2020). Dry Mouth. Retrieved from https://www.nidcr.nih.gov
- S. J. Leung, K. M. M. K. Cheng, & C. Y. M. Mak. (2018). A randomized clinical trial of the effectiveness of different interdental brushes on interdental cleaning. International Journal of Dental Hygiene, 16(1), 91-99.
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