Dr. Karen Clark is an Assistant Professor of Science at Davenport University. She earned her bachelor of science in Clinical laboratory Science at Michigan Technological University in 1996 and her bachelor of science in Human Biology in 1998 and her doctorate of chiropractic at National University in 2000. She sold her chiropractic practice to pursue her passion of teaching full time at the undergraduate and graduate level. She has been at Davenport University for 20 years teaching Anatomy & Physiology lectures and labs, and Pathophysiology in the College of Arts and Sciences. She has received two outstanding teacher of the year awards, has presented on best teaching practices, advises student organizations and is a capstone mentor for the Biological Laboratory Science program at Davenport University.

Course Description

This course provides an overview on the biology of cancer, contrasting the characteristics of benign and malignant tumors. The etiology of cancer will be introduced, focusing on the genetic basis of cancer and host and environmental factors that have been linked to cancer.    

Objectives

1. Compare benign and malignant tumors
2. Discuss the characteristics of malignant cells
3. Describe the process of metastasis
4. Explain how mutations and epigenetic changes to proto-oncogenes and tumor suppressor genes contribute to the development of cancer in the cell cycle
5. Relate the effects of environmental factors and host factors to the risk for cancer development

BIO

Katie Charles, BSN, RN has worked as a nurse for over a decade. Katie received her nursing degree from the University of Illinois. She has worked in a variety of settings, including cardiology, oncology, gastroenterology, emergency medicine, and surgery. Katie understands the intricate balance of working in interprofessional teams in a complex healthcare system, as she has served on several advisory boards and committees for her hospital.  She has a unique perspective in that she respects traditional medicine yet values a holistic approach to provide whole person care that focuses on prevention.

UNDERSTANDING LAB WORK (coming soon)

Mechanical Ventilation and Tracheostomy Care for Oncology Patients and Caregivers

As a member of the oncology interdisciplinary team, it is imperative the dental hygienist understands critical care management outside the traditional scope of practice and into bedside care and assistance. In severely immunocompromised oncology patients, there is the possibility of tracheostomy and ventilator dependence. Students will learn when each intervention is indicated, risks associated with a ventilated patient and how to provide oral care and understand the dental hygienist’s role in preventing hospital-acquired infections. 

Objectives 

1. Differentiate between a ventilator and tracheostomy and uses for each. 
2. Define ventilator-associated pneumonia, signs and symptoms, and oral care strategies for ventilated patients. 
3. Identify key educational pieces to share with caregivers and other health professionals regarding oral care on a ventilated patient.

BIO

Elizabeth Jinks, RDH, BS began her dental hygiene career in 1981 at Parkland College. Liz first began her career in private practice and began teaching shortly after. She quickly realized how much she loved to share her knowledge and experience with others. This ultimately inspired her to complete her bachelor’s degree. During her time at Parkland College, Liz taught several courses, including head and neck anatomy, local anesthesia, pharmacology, preclinic, seminar, seminar 3 and many laboratory courses. One of the most memorable highlights of her professional career include receiving the Part-time Faculty of the Year award. Her career in teaching has always been fulfilling and truly rewarding.  

Liz has a unique perspective in teaching subjects in oncology, as she was diagnosed with invasive ductal carcinoma, triple positive breast cancer (stage 1) in December 2017. She started her cancer journey in January 2018 with six chemotherapy treatments, immunotherapy, surgery and twenty radiation treatments. Her thirteen years of teaching pharmacology gave her the advantage of knowing about the medications she was receiving.  Liz’s cancer journey allowed her to understand the correlation between real life and the subject matter.  

COURSE OBJECTIVES

This two-part course will present chemotherapeutic drugs with an overview of their basic drug classifications, mechanisms of action, and the adverse effects they have on the oral cavity including osteonecrosis of the jaw, mucositis, oral fungal infections, and oral herpetic lesions.

Part 1 Objectives 

1. Identify the human and environmental carcinogens that may be involved in the etiology of cancer.
2. Discuss the pharmaceutical medications that may be prescribed during the initial cancer diagnosis, cancer treatment, and post cancer treatment their dental considerations.
3. Explain the four common treatments used to treat cancer.
4. Discuss chemotherapeutic agents and summarize their use, mechanism of action and classifications.

Part 2 Objectives

1. Identify the general adverse drug effects associated with chemotherapeutic agents.
2. Discuss the following oral adverse effects associated with chemotherapeutic agents: osteonecrosis of the jaw, mucositis, oral fungal infections, and oral herpetic lesions.
3. Summarize the pharmaceutical agents that are suggested/recommended to treat each of the aforementioned oral adverse effects.

BIO

Since becoming a credentialed dietitian in 2020, Zak has dedicated his career to helping others improve their relationship with food and eating. His first position was as an Oncology and Clinical Dietitian in Decatur, IL. As an Oncology Dietitian, his roles were to assess patients undergoing cancer treatment, manage use of feeding tubes or nutrition support, and provide education for reduction of cancer risk. Zak also enjoys tutoring students preparing to become dietitians, as well as producing and recording his video project, The Diet NPO Podcast.

Course Description

This course outlines the role of nutrition care in cancer and oncology treatment. The course discusses the role of registered dietitians in the medical care of patients with cancer. This includes the dietary recommendations for cancer, side effects of cancer and its treatment, as well as the use of nutrition support for cancer patients.

Objectives

1. Identify nutrition recommendations, foods, and beverages for cancer patients undergoing treatment.
2. Outline nutrition-related symptoms and side effects of cancer and its treatment.
3. Specify the indications for nutrition support through a feeding tube or intravenous (IV) nutrition. 
4. Define dietary and lifestyle habits to prevent cancer and reduce risk of cancer recurrence.

BIO

Susan Cotten BSDH, RDH, OMT, is dentistry’s oral cancer coach! She lives and breathes early detection of oral cancer, comprehensive screening on every patient, and reducing liability.

There was a time in Susan's dental hygiene career that this was not the case, she knew very little about oral cancer and was neither confident nor thorough when performing an oral cancer screening. It was two events within the same week, a heartbreaking conversation with her favorite patient who is an oral cancer survivor and being selected for Donny Osmond's Make a Difference program, which acted as catalysts for her passion and deep dive into oral cancer.

Susan is the founder and CEO of Oral Cancer Consulting, she developed the "Cotten Method," the most advanced method of screening for head, neck, oral and oropharyngeal cancer for dental providers to date. She works with dental offices and DSOs to increase confidence in screening, aid in early detection, reduce the risk of liability and increase rates of survivorship.

Susan is an international speaker, consultant, author, and the Dental Workgroup Lead for the Alliance for HPV Free Colorado where she develops and delivers training on HPV, HPV vaccine, HPV-associated oropharyngeal cancer, and screening. She is the oral cancer screening coordinator for Colorado Mission of Mercy, and a Regional Coordinator and RDH Advisory Board member for The Oral Cancer Foundation.

She is a 2018 recipient of the Sunstar RDH Award of Distinction and the 2018 recipient of the Colorado Dental Hygienists’ Association Outstanding Contribution Award, she also received the Ethel Covington Award from the Colorado Dental Hygienists’ Association in 2020. Susan founded MAD (Make A Difference) for Healthy Smiles as a 2010-2011 member of Donny Osmond’s Make a Difference program and received the Volunteer of the Year from the Oral Cancer Foundation in 2011. She graduated from the University of Colorado School of Dental Medicine, Department of Dental Hygiene in 1994, and completed advanced coursework in Orofacial Myofunctional Therapy. On a personal note, Susan loves gardening, watching college football, and visiting the beautiful Hawaiian Islands.

COURSE DESCRIPTION

Conducting a Thorough Head, Neck, Oral & Oropharyngeal Cancer Screening Utilizing the “Cotten Method”

This course is designed to examine the components of a comprehensive head and neck evaluation and increase confidence in performing this critical life-saving procedure. This course is based on the four science-based pillars of screening in the “Cotten Method” of screening; etiologies, risk factors, signs and symptoms, and the visual and tactile, extraoral, and intraoral evaluation. This course will demonstrate why the four pillars are essential in a comprehensive screening. 

Module One 

It’s important to have a solid knowledge base of the known etiologies of head and neck, oral, and oropharyngeal cancers. Module one will look at tobacco, alcohol, betel quid, and the Human Papillomavirus/HPV.

Objectives:

1. Discuss the ramification of tobacco and alcohol 
2. Summarize the role of Betel Quid in oral cancers
3. Examine the Human Papillomavirus, transmission of HPV, how HPV causes cancer and the HPV cancer vaccine.

Module Two 

It is widely known that tobacco and alcohol are etiologies of head and neck cancers, what isn’t widely known are the additional risk factors for oral cancer. Just as cardiovascular disease and other systemic conditions have a variety of things that can increase the risk of these conditions, so does oral cancer. This module will explore these risk factors.

Objectives:

1. Recognize additional risk factors for oral cancer
2. Describe the importance of an oral cancer risk assessment
3. Explain the importance of regular oral health appointments for the edentulous patient

Module Three 

Dental professionals are provided a solid education on the visual variations of normal that can occur in the oral cavity, and also on the characteristics of an oral cancer lesion. What is known now, there are signs and symptoms of head and neck cancers that may occur before a lesion is identified in the oral cavity. This module will discuss those signs and symptoms.

Objectives:

1. List the signs and symptoms associated with head and neck cancers and other conditions
2. Recognize the importance of a verbal and written inquiry of signs and symptoms
3. Name the ten symptoms of cancer that shouldn’t be ignored

Module Four 

Oral cancer screening is the general term used for a visual and tactile, extraoral, and intraoral evaluation/EOIO. This hands-on evaluation is the gold standard used to evaluate the head, neck, oral cavity, and oropharynx for any abnormalities and possible signs of cancer that may require a referral to a specialist for further investigation. This module will utilize instructional videos to examine components of a comprehensive EOIO, palpation techniques, patient and provider positioning, and anatomical structures in the oropharynx.

Objectives:

1. Demonstrate a comprehensive extraoral evaluation with best practices in palpation and positioning
2. Demonstrate a comprehensive intraoral evaluation with best practices in palpation and positioning
3. List the anatomical structures evaluated in the intraoral evaluation

Module Five 

This module discusses the updated oral cancer policies adopted by the ADA and ADHA, liabilities, thorough documentation, and coding for this critical procedure when it is performed outside of a traditional dental setting. 

Objectives:

1. Summarize the ADA and ADHA oral cancer policies
2. List areas of potential liability 
3. Describe thorough documentation 
4. Name and explain available CDT codes for an oral assessment and screening of a patient

BIO

Jennifer was born and raised in Colorado Springs, Colorado. She has been a practicing dental hygienist for over 20 years. In 2018 she received her bachelor’s in dental hygiene, and has since achieved her certification as a tobacco treatment specialist and holds a certificate in Oral Systemic Education through National Network of Healthcare Hygienists. In January of 2019, she and her family moved to Arkansas as she was recruited to develop a dental hygiene role at CARTI Cancer Center and has since taken on the role of manager of the dental department.

Jennifer has dedicated her career and education to helping address the oral health needs of cancer patients. She spent eight years in two hospital setting cancer centers in Colorado, and is now in her fourth year navigating dental care for head and neck cancer patients at CARTI Cancer Center in Little Rock, Arkansas. CARTI’s values and vision have allowed the development of a state-of-the-art dental clinic and full-service dental team. Jennifer focuses her time on patients' dental needs prior to the start of radiation and/or chemotherapy therapy, including clinical hygiene, educating patients on the importance of oral care during treatment, and collaborating with their dental home ensuring they receive recommended post treatment care. Cancer patients face an incredible journey and Jennifer is honored and proud to play a key role in their support and success. 

Aligning with CARTI’s value of innovative approach, the dental clinic is addressing the recognized need for oral health support for all cancer patients and has developed a streamlined protocol for patients at risk for Medication Related Osteonecrosis Necrosis of the Jaw (MRONJ). Most recently, her team has started the development of a multidisciplinary support service clinic, and Jennifer will utilize her TTS certification in the new lung screening program. 

Jennifer strives to continue developing and integrating oral health education and services within the cancer clinic to address access to care. In addition, her hope is to increase interprofessional collaboration between medical and dental teams to improve the patient’s quality of life and overall well-being.

COURSE DESCRIPTION The Initial Dental Assessment on an Oncology Patient with Dr. Megan Reutter

The initial dental appointment involves a multitude of tasks: from learning the patient’s cancer and treatment regimen to educating the patient and caregiver on dental implications, and so much more. From this course, students will be well equipped to conduct the initial assessment appointment with an oncology patient and establish a relationship with them as they begin their cancer journey. This course provides a unique blend of education and personal stories from a dental hygienist specializing in oncology in a hospital setting.  

Objectives 

1. Identify key initial assessment components on an oncology patient.
2. Discover oral health care regimens and appointment sequencing for each type of cancer treatment. (RT, CT, HSCT)
3. Recognize potential workflows for the dental hygienist on an interdisciplinary team.

BIO

Megan Reutter, RDH, DHSc is a dental hygienist, educator, published researcher and oral health advocate. She has worked in a variety of settings, including clinical practice, education, and public health.  She serves as a Trustee and Student Relations Chair for the Illinois Dental Hygiene Association. Megan’s research interest is interprofessional education and has presented her research at several seminars. She is passionate about educating the public and other health professions on the oral-systemic link.

Megan’s Doctorate focused on Leadership and Organizational Behavior from A.T. Still University.  In addition to interprofessional education, she is also passionate about leadership and evaluating leadership roles in multidisciplinary teams.  

Dr. Reutter works in private practice and serves as adjunct faculty at multiple universities including Parkland College in the dental hygiene program, University of Illinois in the Community Health program, and Campbell University in the Doctor of Health Sciences program. 

She is instructing or co-lecturing four courses, and is our Curriculum Director:

1. Secondary complications during cancer treatment (Part 1) with Jill Meyer-Lippert

2. Initial dental assessment on an oncology patient with Jennifer Brown

3. Interprofessional aspects in oncology care with Katie Charles

4. Secondary complications during cancer treatment (Part 2 solo)

In myelosuppressed cancer patients, the oral cavity can be a source of systemic infection. Particularly in oral cancers and radiation to the head and neck region, irreversible damage can occur to the oral mucosa, vasculature, and muscle and bone, resulting in xerostomia, rampant dental caries, trismus, soft tissue necrosis, and osteonecrosis. Opportunistic infections can also wreak havoc on the oral cavity. Management of oral complications on cancer therapy includes identification of high-risk populations, patient education, initiation of pretreatment interventions, and timely management of lesions. This course includes both preventive and therapeutic recommendations to minimize the risk of oral and associated systemic complications. 

Course Objectives

1. Identify the cause, symptoms, and oral manifestations of: osteonecrosis, acute periodontal infections, candida infections, herpes simplex, and trismus. 
2. Evaluate prevention modalities of each.
3. Identify critical education pieces to share with your patient undergoing cancer treatment and their caregiver.

BIO

Jill has worked in dentistry for 30 years with over 25 years as a clinical Dental Hygienist. She is the founder of Side Effect Support, an online resource for cancer patients, family caregivers, and healthcare providers to reduce harmful oral side effects of treatments, improving quality of life and treatment outcomes. Jill is a 2014 recipient of the Sunstar Americas/RDH Award of Distinction, holds a certificate in Oncology Management, and provides consulting services with Custom Dental Solutions. She is a member of the Registered Dental Hygienist Advisory Board for the Oral Cancer Foundation, the Inside Dental Hygiene Advisory Board, Teethcloud Thought Leaders, and was named as one of the “6 Dental Hygienists You Want to Know” by Dimensions of Dental Hygiene magazine.

COURSE DESCRIPTIONS

1. Providing Oral Care During Cancer Treatments with Dr. Megan Reutter

Oral mucositis is a common and debilitating complication of cancer therapy. In addition to extreme discomfort, oral mucositis can also lead to increased hospitalizations and mortality rate, compromised nutritional status, and have significant financial burden. This course will provide an evidence-based summary of the clinical presentation, epidemiology, assessment, risk prediction, and current intervention strategies of oral mucositis. Understanding these concepts will allow dental hygienists to provide effective, personalized mucositis interventions and improve the quality of life for patients undergoing cancer therapy. 

Course Objectives:

1. Identify the cause, symptoms, and clinical manifestations of oral mucositis. 
2. Evaluation prevention modalities of oral mucositis.
3. Identify critical education pieces to share with your patient undergoing cancer treatment and their caregiver.

2. Oral Hygiene Modifications & Product Consideration

Oral side effects and untreated dental diseases can cause added pain, financial hardships, and psychological distress for those being treated for cancer. They can also lead to complications or delays in treatments, which can compromise treatment outcomes. Oral changes may have a continued negative impact throughout survivorship.

While highlighting the human element of cancer care and quality of life issues, this presentation will provide tools for a well-rounded approach to optimal patient care through a focus on prevention, patient education, and product selection.

Course Objectives

1. Determine the value of preventive oral care with treatments and survivorship.
2. Identify homecare modifications to reduce complications.
3. Examine product pros and cons.
4. Provide additional resources for continued support.

BIO

Sara Jane is the dental and oncology specialist for THOR Photomedicine, expanding the use of photobiomodulation (PBM) in dental practices and oncology centers for the benefit of both patients and providers. She is passionate about whole-body health and collaboration between different fields, as she has seen how different perspectives of team-based care leads to better overall care for oncology patients. 

She especially loves working with cancer treatment facilities. She helps the medical staff feel confident and empowers them to use technology to help fight cancer therapy side effects. She is moved to continue this important work by the incredible success stories that come back to her regarding PBM. She sleeps well at night knowing patients are getting through their cancer therapy without delays in treatment, without feeding tubes, or needing opioids because they don’t have debilitating side effects. 

Sara Jane is also a dental hygiene instructor at Montgomery Community College in Pennsylvania. She loves watching her students think critically and see the whole patient as an avenue to learning and growing as a healthcare provider.

She still finds time to temp clinically once in a while, and loves the challenges and rewards of guiding her patients to optimize their overall health through better oral health.

Course Description

The aim of this course is to understand the technology of photobiomodulation (PBM), (previously known as LLLT or cold laser) and how it is used around the globe for oncology patients. We will identify what PBM is, how it works, who can use it, when/how treatment is applied, and where in the USA it is being used for oncology patients. This course will focus on using PBM for the cancer therapy side effect of oral mucositis. We will also discuss a few other PBM cancer therapy side effects applications such as oral graft vs host disease (GVHD), radiation trismus, and xerostomia.

Objectives

1. What is Photobiomodulation (PBM)?
2. What does PBM do for your patients?
3. Define the mechanism of action
4. Know the difference between class 3B, class 4 lasers and LED’s for PBM use
5. Understand the research and guidelines endorsing PBM for the treatment of cancer therapy side effects such as oral mucositis

BIO

Roxanne Dsouza-Norwood, MS, RDH, is an assistant professor in the Dental Hygiene Programs at the University of North Carolina at Chapel Hill (UNC) Adams School of Dentistry, Division of Comprehensive Oral Health. In her current role, she works with dental, undergraduate dental hygiene, and graduate dental hygiene students in research projects, didactic education, and clinical education. She is the second-year dental hygiene clinic director and directs undergraduate dental hygiene honor’s thesis and periodontology courses. She has a background in both education and research and has presented her research nationally. She has also participated in and led several interprofessional initiatives across healthcare disciplines at UNC. She has a passion for interprofessional education and is dedicated to educating compassionate healthcare clinicians dedicated to whole-person centered care. Roxanne is an active member of the American Dental Hygienists’ Association, North Carolina Dental Hygienists’ Association, American Dental Education Association, president of Sigma Phi Alpha–Xi Chapter, and East Regional Chair of Sigma Phi Alpha–Supreme Chapter.

Course Description

Dental hygienists provide care for patients across all stages of cancer therapy. Following cancer therapy care, should be addressed utilizing an individualized approach of assessing patient goals of care and appropriate recall intervals. Additionally, short-term and long-term considerations following specific cancer therapies must be evaluated in collaboration with the oncology team. This course provides recommendations for dental hygiene providers in the oral care for patients following the completion of cancer therapy. Emphasis will be placed on person-centered and collaborative care. 

Objectives

1. Collaborate with the oncology team and healthcare providers on the current status of cancer treatment.
2. Describe potential short-term and long-term oral health considerations following specific cancer therapies.
3. Provide individualized care for patients who have undergone cancer therapy.
4. Establish an appropriate recall interval.