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P Stevenson-Moore

Publications and source records attributed to P Stevenson-Moore.

At least 19 recordsLinked to original sources
PubMed1999

Quality of life and oral function following radiotherapy for head and neck cancer.

BACKGROUND: Multiple oral complaints occur following radiotherapy for oropharyngeal cancer, but the frequency and severity of symptoms of dysfunction and discomfort are not well understood. The purpose of this investigation was to assess the quality of life, oral function, and oral symptoms following radiotherapy. METHODS: A general quality of life survey (the European Organization for Research and Treatment of Cancer [EORTC] Quality of Life Questionnaire QLQ-C30), with an added oral symptom and function scale was mailed to 100 patients more than 6 months following radiotherapy. RESULTS: Sixty-five patients responded. Difficulty chewing or eating was reported by 43% of respondents. Dry mouth was reported by 91.8%, change in taste by 75.4%, dysphagia by 63.1%, altered speech by 50.8%, difficulty with dentures by 48.5%, and increased tooth decay by 38.5% of dentate patients. Pain was common (58.4%) and interfered with daily activities in 30.8%. Mood complaints were reported by approximately half the patients. Interference of the physical condition social activities was reported by 60%. The frequency of oral side effects correlated with radiation treatment fields and dose. CONCLUSION: Oral complications following radiotherapy for head and neck cancer are common and affect quality of life. Use of a general function scale such as the EORTC questionnaire with the addition of disease/site specific scales may provide useful data on outcome of therapy and upon the complications associated with therapy and impact upon the quality of life.

Adult↗
PubMed1999

A double-blind crossover trial of Oral Balance gel and Biotene toothpaste versus placebo in patients with xerostomia following radiation therapy.

Following therapeutic irradiation of the head and neck, patients with profound xerostomia have complaints associated with oral dryness, effects upon use of oral prosthesis, speech, and taste. In addition, xerostomia may lead to risk of oral infections and rampant demineralization of teeth. The use of topical Oral Balance gel and Biotene toothpaste (Laclede Professional Products, Gardena, CA) versus carboxymethylcellulose gel and commercial toothpaste applications was assessed in a 2-week double-blind, crossover design. The palliative effects of Oral Balance gel and Biotene toothpaste were superior to the effects of a placebo. No effect on oral colonization by Candida species and cariogenic oral microflora was seen with use of the topical agents.

Adult↗
PubMed1998

Periodontal attachment loss in patients after head and neck radiation therapy.

OBJECTIVE: The purpose of this study was to determine the potential impact of head and neck radiation therapy on the progression of periodontal attachment loss. STUDY DESIGN: Ten patients who received unilateral radiation fields that included the dentition were assessed before radiation treatment and after irradiation at a mean age of 6.01 years. Complete oral, dental, and periodontal examinations were completed by one examiner. The results were assessed through use of paired t tests. RESULTS: More teeth were extracted because of periodontal disease in the field of radiation after irradiation. Remaining teeth in the radiated volume showed an increase in probing depth of 0.82 mm in comparison with 0.40 mm for teeth in the nonradiated region (P = .05). Recession on the facial aspects was 1.88 mm for teeth in the radiated volume and 1.16 mm for teeth in the nonradiated region (P = .001), and recession on the lingual aspects was 2.10 for teeth in the radiated volume and 0.91 for teeth in the nonradiated region (P = .05). Mean total attachment loss was 2.81 mm for teeth in the radiated sites; this compared with 1.43 mm for teeth in the nonradiated sites (P = .003). Increased mobility of teeth in the high-dose fields was seen (P = .02). CONCLUSIONS: This study showed that tooth loss and greater periodontal attachment loss occur in teeth that are included within high-dose radiated sites of patients treated with irradiation therapy for cancer. These findings should be considered in preradiation treatment planning.

Adult↗
PubMed1998

FluoriSHIELD.

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Buffers↗
PubMed1997

Postradiation osteonecrosis of the mandible: a long-term follow-up study.

OBJECTIVES: The objective of this study was to assess the long-term progress of 26 patients who experienced postradiation osteonecrosis of the jaw between 1975 and 1989. STUDY DESIGN: Of 26 patients who had been previously managed with hyperbaric oxygen therapy as a part of their treatment for postradiation osteonecrosis of the jaw, 20 were evaluated to determine their current status of the condition: resolved, chronic persisting (unresolved), or active progressive (symptomatic). RESULTS: Two of 20 patients experienced recurrences of the condition. In one of these patients, surgical treatment was identified as the stimulus of postradiation osteonecrosis. In the other patient, the recurrence appeared to be related to periodontal disease activity. In 60% (12 of 20) of the patients, the condition remained resolved, improvement in clinical staging occurred in 10% (2 of 20) (from symptomatic to unresolved or resolved), and 20% (5 of 20) of the patients continued to demonstrate chronic persisting postradiation osteonecrosis at the end of the long-term follow-up period. CONCLUSION: This study supports the contention that postradiation osteonecrosis can occur at any time after radiation therapy, and that patients remain at risk up to 231 months after treatment of the cancer and probably indefinitely after radiation therapy. Our findings also suggest that risk of second episodes of the condition after management of an initial episode is low. In addition, our follow-up study revealed that chronic nonprogressive postradiation osteonecrosis can remain stable without extensive intervention including combined hyperbaric oxygen therapy and surgery.

Adult↗
PubMed1996

A comparison of computed tomography and panoramic radiography in assessing malignancy of the maxillary antrum.

Panoramic and computed tomographic images of 20 patients with antral malignancy were viewed separately and compared to determine the extent of bony destruction of the sinus walls seen in each film type. This study showed that panoramic radiographs can demonstrate antral malignancy at the time of diagnosis in 90% of cases. Panoramic radiographs possess the potential for identifying the need for further diagnostic procedures in evaluating the maxillary antrum. Health care workers should be aware of the value of panoramic radiographs in examining this region.

Aged↗
PubMed1996

Effects of compliance with fluoride gel application on caries and caries risk in patients after radiation therapy for head and neck cancer.

The use of fluoride gel applied in a custom tray once daily has become standard for patients who have xerostomia after undergoing radiation therapy. Compliance may be poor as a result of the inconvenient method of application and because many patients with head and neck cancer have poor health behaviors. Our aim was to investigate the effect of compliance with fluoride gel application on caries and caries risk. Patients were prescribed neutral sodium fluoride gel (5000 ppm) before undergoing radiotherapy Fifty-two patients were willing to visit the dental clinic for dental examination, measurement of saliva, and quantitative culture of Streptococcus mutans and lactobacillus species. Before radiotherapy was performed, decayed, missing, and filled surfaces data were recorded for all patients in the study. Of these patients, 27 used fluoride gel once daily, as directed. Radiation dose, number of fractions, and duration of radiation had a significant inverse effect on postradiotherapy whole resting saliva (p = 0.04, p = 0.01, and p = 0.01) and on whole stimulated saliva (p = 0.02, p < 0.01, and p < 0.01). Patients with a subjective feeling of dry mouth had significantly less saliva production at rest (p = 0.01) and on stimulation (p = 0.01). A trend toward reduction of S. mutans counts was seen in those patients who used their fluoride gel regularly (p = 0.057). High lactobacilli counts were found in the patients with high and low compliance with fluoride gel use. Differences in the mean caries incidence between those who reported compliance with daily fluoride application and those who did not comply were not found significant because of the large SD in the patient groups, although differences in the mean for these groups were seen. The lack of a statistically significant difference may be due to the multiple factors associated with caries. Therefore patient care must be individualized, and patients must be assessed at regular intervals to determine the caries risk and caries activity to provide guidance for maintenance of the dentition.

Adult↗
PubMed1996

Denturists.

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British Columbia↗
PubMed1992

The development of osteoradionecrosis from sites of periodontal disease activity: report of 3 cases.

Osteoradionecrosis may develop following radiation therapy that involves bone, and most particularly following treatment of cancers within the head and neck. The mandible is at greatest risk of osteoradionecrosis because of the nature of its blood supply and its dense bone configuration. This paper describes 3 cases which demonstrate the development of osteoradionecrosis in the mandible from sites of periodontal disease activity following external beam radiotherapy. The pathogenesis of these events is reviewed, and recommendations for their management are discussed. A proposal for the use of chlorhexidine digluconate and hyperbaric oxygen in the periodontal management of this condition is outlined.

Aged↗
PubMed1992

Management of xerostomia.

Xerostomia (dry mouth) is an unpleasant condition that is common after radiotherapy to the head and neck, although it may have other causes. A review of the management of xerostomia, as well as the prevention and management of the oral soft tissue and dental complications resulting from xerostomia, is provided.

Candidiasis, Oral↗
PubMed1991

The efficacy of chlorhexidine gel in reduction of Streptococcus mutans and Lactobacillus species in patients treated with radiation therapy.

Xerostomia may develop in patients with cancer who receive radiotherapy that includes the salivary glands in the field. These patients are at high risk of rampant dental caries. Streptococcus mutans and Lactobacillus species have been associated with dental caries. Quantitative counts of these organisms demonstrated high caries risk due to streptococci in 66% and due to lactobacilli in 100% of patients studied. Use of chlorhexidine rinse was shown to reduce S. mutans counts 1.1 logs and lactobacilli 1.1 logs. The use of chlorhexidine gel resulted in a reduction of S. mutans 1.2 logs and lactobacilli 2.2 logs. In the subjects using the rinse, caries risk due to streptococci was reduced to low levels in 44% and due to lactobacilli in only one subject, with reduction to moderate risk in one third and no change in risk in the remaining patients. The use of chlorhexidine gel was found to reduce the caries risk associated with streptococci to low levels in all patients, and the risk associated with lactobacilli to low and moderate risk in two thirds of patients.

Adult↗
PubMed1990

Oral complications of cancer therapies. Essential aspects of a pretreatment oral examination.

Certain disease entities or their management impose conditions that heighten risks of oral complications or systemic complications of oral origin. The pretreatment oral examination attempts to identify the main factors that will cause risk so that steps may be taken to control or eliminate as many as practical before treatment is begun. Additional tests may be indicated to provide more detailed information on which to base clinical diagnoses and oral therapy.

Dental Plaque↗
PubMed1989

The Vancouver microstomia orthosis.

Eighteen microstomia orthoses are compared with respect to their characteristics, use, and limitations. A new prosthesis, the Vancouver microstomia orthosis, was designed to incorporate the advantages of many of the orthoses and eliminate some drawbacks. Ten adults with microstomia secondary to second- or third-degree circumoral flame burns were fitted with the prosthesis and observed over a 12-month period. In 9 weeks or less, microstomia was corrected with an average gain of 7 mm in the horizontal and 13 mm in the vertical active range of motion. The measures before and after this treatment were statistically significant for increase in both dimensions (paired t-test, p less than .01).

Adult↗
PubMed1989

Chlorhexidine rinse in prevention of dental caries in patients following radiation therapy.

Patients who receive cancer radiotherapy, which compromises salivary gland function, may develop xerostomia. These patients are at increased risk to develop rampant dental caries. Streptococcus mutans and species of lactobacillus have been associated with dental caries. Quantitative counts of these organisms demonstrated high caries risk in 85% of patients studied. The use of chlorhexidine rinse to reduce the counts of S. mutans and lactobacillus was studied. A modest reduction in S. mutans was seen, but little effect was demonstrated on lactobacillus counts. Caries activity was shown to be related to lactobacillus count.

Adolescent↗