Krissie Rike, RDA

Dental Oncology Professionals of North Texas

Garland, Texas

As Krissie Rike, RDA, looks back on her training and career, she has come to believe that dental assisting programs should offer more medical training on how the oral cavity is linked to systemic health. “We have to change the way we approach dentistry as a whole,” she says. “Cancer and other diseases wreak havoc on our patients’ systemic and oral health.”

The death of her father at a young age fueled Rike’s interest in the healthcare field. “I went through so much with him during his illness,” she explains. “I always wanted to help people, either as a nurse or in the dental field. A few of my friends who were already in oral healthcare got me really interested.”

Rike chose the dental assisting program at Collin County Community College in Dallas. “Back then, it was a 10-week program,” she explains. “A few years later, dental assistants were required to be registered in the state, and I returned for some additional examinations to be registered in CPR and radiation.”

After graduating, Rike joined the practice of Dennis Abbott, DDS, before the focus of the practice changed to dental oncology. “There isn’t a lot of training for dental assistants in dental oncology,” she says. “It was on-the-job experience, learning to work with oncology referrals.”

With the shift to oncology, the oral medicine practice became dedicated to meeting the unique oral healthcare needs of individuals battling all forms of cancer at all stages. The team treats and manages oral side effects and complications that are a result of chemotherapy, radiation, or other treatments such as bone marrow and stem cell transplants.

“We customize a treatment plan for each individual, because everybody’s experience is different,” Rike explains. “It’s never the same plan. They are all on a different path with their illness and their treatment, and it’s up to us to help ease the journey.”

The patients experience side effects such as mouth sores or extreme dry mouth. Without the protective qualities of saliva, these patients have an increased risk for severe dental decay and are more susceptible to all kinds of infections: bacterial, fungal, and viral. In these immunocompromised patients, such infections can necessitate delay in the scheduled cancer treatment or even be life-threatening.

Rike says it’s impossible to work with her patients and not gain a new perspective on life. “We see our patients every 2 to 4 weeks, so we get to know them really well. At the end of the day, it’s incredibly rewarding to look back on the different opportunities we have to help patients.

“Our practice is so different from a general practice,” she adds. “I would really encourage anyone wanting to become a dental assistant to investigate these different areas, get into something that’s rewarding and interesting to you.”

The challenge is to design individual plans, staying current with each patient’s illness and treatment side effects. Rike works directly with oncology team nurses to acquire a history of the patient’s illness, request an isodose map for patients receiving head and neck radiation, and order current blood work to ensure that each patient’s white blood cell count indicates it’s safe for dental treatment before any procedures.

A significant portion of Rike’s work is communication with the oncology practices. “Before we see a new patient, I work with the oncology nurses, and they fax over history of illness, personal history, current blood work, and any notes we’ll need. We have developed such a great relationship and line of communication with our oncology doctors and staff.”

With information in hand, the dental team meets with new patients in a consultation room first, in a “nondental” setting to initiate the oral health part of their treatment.

Most of the team has been in the practice long-term (at least 8 years), and they’ve formed close friendships and great communication. “It’s fun to come to work; you know everyone has your back,” Rike says. “Our patients’ families get to know us, too, writing us letters and bringing us treats in thanks. We work very hard at making the atmosphere in the office friendly and supportive.”

According to Rike, their days start off early at 7:15 a.m., but with great energy. “We have a morning meeting every day, give each other hugs, and head off to days that are never the same from one to the next.”

Their days don’t end early, either. The team also does various community outreach programs, from free oral cancer screenings at clinics and oncology offices, to education meetings about the dental components of having cancer. “We are kind of on a mission to change the education and care of patients with cancer,” Rike says. As the coordinator of community outreach, she sets up the locations, communicates with clinic personnel, takes medical histories, and assists with screenings.

Rike would like to generate more awareness for dental oncology “and how we treat patients who are on a cancer journey, because they have unique oral health needs. I think oral healthcare is becoming more focused on the medical–dental link. We treat patients as a whole, not just someone needing a filling or a crown. I hope dentistry will continue to evolve from there.

“We all know someone with cancer or who knows someone who has cancer, and they often don’t know what to do about their oral health,” she adds. “If they have oral problems, sometimes even oncologists don’t always know what to do.

“I always wonder what more we can do to educate patients, to help them understand that during this time oral healthcare professionals should be part of their cancer care team, and that we will be there for them as they continue through their survivorship years.”

Rike admits that working with patients who are being treated for cancer is a special environment and challenge. “Some of them will pass away,” she says. “We have to believe while they were here battling the cancer, we were able to help them with their health and quality of life. We often hear from their families afterwards.

“If you love helping and caring for people, this is an rewarding and exciting career,” Rike says. “The work is constantly changing and evolving—and I believe eventually the profession will evolve into helping more patients with their overall health.”