Speaking and Continuing Education

Dr. Epstein is an internationally known speaker in clinical oral medicine and oral oncology. He is highly published in the topics he presents. Please contact any of the office locations for enquires and planning.

Dr Epstein is a clinician educator, and has been active in education throughout his career; He has spoken to study groups, residency programs and large research meetings, conventions and continuing education in dental and medical programs. He has been university based and is active in academic medical centers.

Presentations are directly related to patient care, clinical, evidence based and based upon current guidelines and recommendations for practice. Presentations are current, evidence based, based upon pathobiology of the condition, current guidelines in the literature, and upon continuing research. Dr. Epstein has played a leading role in guideline development in mucositis, oral care in oncology and skin toxicity and geriatric study groups of the leading guidelines developing organization in oncology, the Multinational Association for Supportive Care in Cancer.

Previous presentations given are listed on the web site.

Recent Topics in Oral Medicine

Sexually transmitted disease and dental practice
Diagnosis and management of common oral lesions
Early detection, diagnosis and management of oral premalignant lesions
Oral function and nutrition
Burning mouth syndrome
Taste
Hyposalivation and oral care
Antimicrobial prophylaxis in dental practice: biology and changing guidelines
Bisphosphonate necrosis and new osteolytic inhibitors
Photobiomodulation (level laser light therapy) and head and neck and oral care

Recent Topics in Oral Oncology

Oral Manifestations of Cancer: diagnosis
Oral mucositis: Significance, Etiology, Prevention and Management
Osteonecrosis: Pathogenesis, Prevention and Management
Hyposalivation and oral care
Taste: Physiology, Effect of Cancer Care, Management
Head and neck pain in cancer patients
Oral mucositis
Guidelines for oral and dental care of cancer survivors
Survivorship and End of life Oral Care
Periodontology and cancer
Bone marrow and stem cell transplant: Oral and Dental Care
Diagnosis, pretransplant oral care, acute and chronic oral complications
Transplant Medicine and Oral Care
Oral Graft versus Host Disease
Inflammation and cancer
Oral complications of immunotherapy for cancer

Example of extended programs:

I. Periodontology and Cancer:

This unique program will discuss the importance of periodontal disease and management throughout the cancer continuum, with a goal to discuss and promote understanding of the role of the periodontal disease and periodontal considerations in cancer from diagnosis to survivorship.

Periodontal Considerations in Oncology
Manifestations of Cancer: diagnosis
Infection as a Complication in Cancer Patients
Inflammation and Cancer
Periodontal Considerations in Cancer Care: Pretreatment
Head and Neck Cancer Therapy
Solid Tumor Chemotherapy
Stem cell transplant

Periodontal Treatment Needs and Precautions for Treatment in Cancer Survivors

Head and Neck Cancer Therapy
Solid Tumor Chemotherapy
Stem cell transplant

II. Cancer Patients and Oral Health

Oral cancer is commonly thought to be of oral origin, but oral involvement by systemic cancer may be the first manifestation of disease. The oral health care provider has a responsibility for early detection of premalignant and malignant disease and for diagnosis. The changing epidemiology of cancer is leading to increased presentation of cancer patients to the dental office. The oral care of cancer patients is clearly the role of the dental provider and appropriate care must be provided at the appropriate time. Principles of oral/dental prior to cancer therapy will be presented. Oral complications of cancer therapy are common throughout active treatment of cancer and can be the most debilitating of complications of cancer treatment; prevention and management will be discussed. Cancer survivors represent approximately 4% of the general population and therefore in dental care and may have unique needs and management. The considerations for oral management of cancer survivors will be discussed.

Basic principles:

Cancer Biology
Changing Epidemiology
Advances in cancer care that impact oral care of caner patients

Recognition and diagnosis of cancer presenting in the oral cavity

Pretreatment oral dental assessment and care

Dental treatment in preparation for cancer therapy
Recommendations for prophylaxis of oral complications in cancer care: biology, prevention and management

Oral Complications during cancer therapy: biology, prevention and management

Oral Management Following cancer therapy: Survivorship issues, prevention and treatment; impact of past and ongoing cancer care on dental providers

III. Changing Epidemiology of Head and neck cancer:

            Risk Factors
            Impact of HPV
            Site specificity of HPV
            Biology of HPV associated cancer and impact on therapy
            Risk of secondary cancer
            Cancer therapy in the era of HPV
            Oral Care in Cancer Patients

Oral Premalignant Lesions

Recognition and detection
Currently available modalities
Research in new detection technologies: OCT, Raman, Cytology, Molecular markers (LOH, others), 3D cytology

IV. Advances in Cancer therapy and Dental Management

Current approaches to management: local and systemic therapy, chemoprevention, targeted therapies
Oral care in the current era of cancer therapy

Advances in treatment of HNC and implications for dental care

Principles of cancer therapy: Surgery (including TORS and laser),
Radiation therapy, chemotherapy, targeted therapy, maintenance therapy

Oral care in the current era of cancer therapy

V. Advances in Hematologic Stem Cell Transplant and implications for dental care

Transplant type: Autologous, allogeneic HCT
Conditioning Regimen: Reduced intensity conditioning
Transplant source: marrow, peripheral stem cell, cord blood transplant,
Tandem transplant
Supportive Care: pain, nausea, growth factors
Preventive oral care prior to cancer therapy; during cancer therapy and survivorship

VI. Head and Neck Cancer and Head and Neck Manifestations of distant and systemic

cancers: Recognition and Diagnosis
Current Oral and Dental Treatment and Prevention Strategies for head and neck
cancer therapy:
Early Detection
Current guidelines and evidence base for MASCC/ISOO
Oral Care during HNC Therapy
Current guidelines and evidence base for MASCC/ISOO

VII. Oral Care in Oncology and Quality of Life:

During treatment, early post treatment and survivorship and end of life care
Mucositis:
Impact
Epidemiology
Biology
New Developments and approaches of management

VIII. Head and neck and oral infection in oncology

Oral infection and systemic infection: Bacterial, fungal and viral
Epidemiology, mechanisms, prevention and management

IX. Survivorship of Cancer and Oral and Dental Care

Survivors of cancer therapy now represent approximately 4% of the general population, more likely to be seen for ongoing oral care needs in clinical practice. Increasing research is providing evidence of impact and management.
Current guidelines and evidence base for MASCC/ISOO

X. The oral impact of new targeted cancer therapies

Unique oral complications of targeted cancer therapies have been recognized.
Diagnosis and approach to management.

XI. Taste Function, Dysfunction and Management

Impact upon nutrition
Epidemiology, assessment, mechanisms, impact
Prevention and management

XII. Salivary gland dysfunction:

Quality of life; impact, diagnosis
Management during and following cancer therapy
Prevention and management of dysfunction in the new era of cancer therapy

XIII. Survivorship in Hematopoietic Stem Cell Transplant:

Oral complications: Graft versus Host Disease:
Pathogenesis,
Orofacial manifestations, diagnosis, prevention and management
Dental care

XIV. Head and Neck and Orofacial Pain Management during Cancer Therapy

            Impact
Epidemiology
Biology/Mechanisms
Mechanistically directed therapies: providing effective pain management; clinical guidelines

Day Program (or limited to ½ day)

II. Cancer Patients and Oral Health

Detection and diagnosis of cancer is commonly thought to be limited to oral cancer, however, oral involvement by systemic cancer may be the first manifestation of disease. The oral health care provider has a responsibility for early detection of premalignant and malignant disease and for diagnosis. The changing epidemiology of cancer and increasing cancer survivorship is leading to increased presentation of cancer patients to the dental office. The oral care of cancer patients is clearly the role of the dental provider and appropriate care must be provided at the appropriate time. Principles of oral/dental prior to cancer therapy will be presented. Oral complications of cancer therapy are common throughout active treatment of cancer and can be the most debilitating of complications of cancer treatment; prevention and management will be discussed. Cancer survivors represent approximately 4% of the general population and therefore in dental care and may have unique needs and management. The considerations for oral management of cancer survivors will be discussed.

Basic principles:

Cancer Biology
Changing Epidemiology
Advances in cancer care that impact oral care of caner patients

Recognition and diagnosis of cancer presenting in the oral cavity

Pretreatment oral dental assessment and care

Dental treatment in preparation for cancer therapy
Recommendations for prophylaxis of oral complications in cancer care: biology, prevention and management

Oral Complications during cancer therapy: biology, prevention and management

Oral Management Following cancer therapy: Survivorship issues, prevention and treatment; impact of past and ongoing cancer care on dental provid