Supporting the Oral Health of Kids With Cancer

Jenell Robins, BSDH, RDH, has been in clinical practice for more than 21 years. Recently, she has also taken on the role of oral health educator at Texas Children’s Hospital in Houston working to advance their oral care program in the cancer center. Robins is passionate about educating patients and other health professionals about the oral-systemic link. Her goal is to demonstrate the importance of integrating a preventive oral health care specialist into the comprehensive medical care team. Robins hopes to help create a path for dental hygienists to become part of more collaborative care teams in the near future. She shared her experience as a hospital-based oral health educator with Sunstar Ebrief.

1. Why is dental health so important in pediatric oncology?

Children undergoing cancer treatment often develop oral complications, such as xerostomia, mucositis, jaw pain, gingival hyperplasia, bleeding, and infection, associated with chemotherapy, medications, and radiation therapy. These patients are extremely immunocompromised, putting them at high risk for systemic infections. Oral pathogens can be the cause of these often life-threatening systemic infections. We refer to these infections as mucosal barrier injury–central line-associated bloodstream infections, or MBI-CLABSIs. Maintaining optimal dental health during cancer treatment can help reduce these serious infections. Patients and their parents/caregivers must understand the importance of daily self-care, how to properly perform oral care methods and use recommended products, and the importance of maintaining regular dental exams during and after treatment to help protect patients’ oral health.

2. How did you become involved, as a dental hygienist, in pediatric oncology?

My hospital’s cancer center researched gaps in care delivery related to central line infections and identified education surrounding the oral-systemic link in cancer care as an opportunity for improvement within the cancer center. Without immediate funds available within the current year’s budget, the hospital applied for external grants to bring on a dental professional, specifically a dental hygienist, as soon as possible. A substantial philanthropic gift was received, and I was hired as an oral health educator for the next 4 years to help advance the oral care program in the cancer center to drive infection-prevention strategies.

You can read more about our collaboration project in “A Novel Oncodental Collaborative Team: Integrating Expertise for Central Line- Associated Bloodstream Infection Prevention in Pediatric Oncology Patients” published in JCO Oncology Practice.

3. What do you believe the future holds for this aspect of dental hygiene practice?

We are working to create a framework to demonstrate how dental hygienists can be a part of a collaborative medical care team. I hope that the oral health educator role becomes a standard of care in pediatric cancer centers. I do believe that once the standard is set, we (hygienists) will be included in many other units and teams across hospitals. Our expertise in preventive oral health care is essential in providing comprehensive care. We can help strengthen an area of care that most medical professionals are not experts in.

4. What advice would you give current dental hygienists who may be interested in nontraditional settings?

I would recommend that clinicians consider what direction they would like to go in and talk to people doing that. Reach out to product reps, professional educators, dental hygiene educators, and fellow hygienists to let them know you want to explore other roles for dental hygienists. They may have advice to help you get started, may know someone else that can help, or maybe even know of a job opportunity you can explore. See if there are books they recommend or groups you should join. There may be courses or certifications that can help you become more marketable outside of the dental operatory. Just like we learned how to be a hygienist in a clinical setting, we must develop skills to work in other fields. Know your strengths and work on your weaknesses. I also want to emphasize that you do not need to have everything figured out. You may not know what you will like or excel at until you try it. Remember to believe in yourself and go for it!