Special Care Instructions for Cancer Patients

CYTOLOGIC SMEAR

Indications:
suspected herpetic lesions, candidiasis, leukoplakic lesions that rub off, erythematous lesions (Persistent erythematous lesions should be biopsied.)

Technique:

1. Using a pencil, label the frosted end of a microscope slide with the patient's name.

2. Remove cells from the oral mucosa with a Cytobrush or tongue blade and spread them evenly on the microscope slide.

3. Repeat procedure on a second microscope slide.

4. Spray the slides lightly with a fixative. (Aquanet hairspray works well.)

5. Submit both slides to the pathologist with a provisional diagnosis.

(Link this with the UF Oral Biopsy Service web-site if possible. - Please give me URL)

How to Use Custom Fluoride Carriers (Trays)

1. At bedtime, remove partial or full dentures from the mouth. Brush teeth thoroughly with soft toothbrush and regular toothpaste. Floss teeth by sliding the floss up and down each side of each tooth. Note: It is very important to remove all food and plaque from between teeth before using fluoride. Food and plaque can prevent the fluoride from reaching the surface of the tooth.

2. Place a thin ribbon of the fluoride gel into each upper and lower fluoride tray so that each tooth space has some fluoride. Either 0.4% stannous fluoride (Gel Kam) or 1.1% sodium fluoride (Prevident) may be used. The fluoride can be spread into a thin film that coats the inside of the trays, by using a cotton-tipped applicator, finger or toothbrush.

3. Seat the trays on the upper and lower teeth and let them remain in place for 5 minutes. Only a small amount of fluoride should come out of the base of the trays when they are placed, otherwise, there may be too much fluoride in the trays.

4. After 5 minutes, remove the trays and thoroughly expectorate (spit out) the residual fluoride. Very Important - do not rinse mouth, drink or eat for at least 30 minutes after fluoride use.

5. For head and neck radiation patients, begin using fluoride in the custom trays no longer than one week after radiotherapy is completed. Repeat daily for the rest of your life!! Remember that tooth decay can occur in a matter of weeks if the fluoride is not used properly.

Care for Fluoride Carriers (Trays)

1. Rinse and dry the trays thoroughly after each use. Clean them by brushing them with a toothbrush and toothpaste.

2. Occasionally, the trays can be disinfected in a solution of sodium hypochlorite (Clorox) and water. Use one tablespoon of Clorox in about one-half cup of water. Soak them for about 15 minutes.

3. If the trays become covered with hard water deposits, soak them in white vinegar overnight and brush them the next morning.

4. Do not boil the trays or leave them in a hot car as they may warp or melt.