I participated in a medical/dental mission trip in the remote mountain village of Jean Rabel, Haiti, in 2012. Before we left, the organizers requested that each member of the team read the book, When Helping Hurts: How to Alleviate Poverty Without Hurting the Poor … and Yourself, by Steve Corbett and Brian Fikkert.
The premise of the book focuses on the goal of giving people a hand-up rather than a handout, and the importance of providing those in need with resources that will continue to improve their conditions long after the missionaries leave. The book provides many examples of ways that good intentions actually keep the people intended to receive help in a cycle of long-term harm.
A surprising lack of resources
The information hit home for me in unexpected ways. Early in my long career as a registered dental hygienist, I was a caregiver for family members who had cancer. As I witnessed the side effects of chemotherapy such as dry mouth and mouth sores, I was frustrated with the lack of resources to help alleviate these problems.
I made it my mission to find answers but found that information was scarce even for health-care providers. I learned that some of these oral side effects not only increase risks of pain and infection during treatment but can result in long-term damage to oral health, which negatively impacts physical, emotional, and financial quality of life.
When I became confident with the information I’d gathered, I created a volunteer program to provide oral care kits with product samples and information for patients at a local cancer clinic. I acquired the products through donations from companies that appreciated the opportunity to be involved.
You might also want to read: The dental hygienist’s role in cancer care
This program had been in place for six years when I read the book by Corbett and Fikkert, and this encouraged me to reexamine the products in the kits. Were they really the best choices for these patients or were they included simply because the manufacturer was willing to donate them? After all, the main purpose of the program was to fill the gap in care, not to make myself feel good about taking action.
Not all oral care products are appropriate for the needs of cancer patients. Some of the remedies recommended to patients by medical providers to reduce oral side effects can actually increase the risks of damage to oral health. A great example is sucking on candy, such as lemon drops, to relieve dry mouth. While the problem with this seems obvious to us as dental providers, it’s still a fairly common practice.
There are also many people and nonprofit organizations that donate gift bags for oncology patients to not only help them pass time and stay comfortable during treatments, but also to raise their spirits knowing others care. These care packages often include items intended to reduce common complaints, such as dry mouth and taste distortion. But will they ultimately make patients’ problems worse?
These make problems worse
- Products with drying and potentially irritating ingredients, like sodium lauryl sulfate, can increase risks for oral mucositis
- Strong flavors can feel too sharp for tender tissue and can increase nausea
- Inappropriate selection of toothbrush head sizes and bristles makes plaque removal more difficult and tissue trauma is more likely to occur. This may affect the patient’s ability to brush at all when dealing with certain grades of oral mucositis or limited range of motion with trismus.
- Sugary and/or acidic products such as hard candies can increase risks for caries, erosion, and infection
- Petroleum-based lip balms ultimately keep lips drier and create a dense barrier that can trap bacteria and impurities against the skin, which increases infection risks
When Helping Hurts says that, “If we treat only the symptoms or if we misdiagnose the underlying problem, we will not improve their situation, and we might actually make their lives worse.”
It feels good to do good and make a positive impact in the world. When making product recommendations or assembling gift bags for cancer patients, it’s important to evaluate if they are appropriate choices for patients’ unique needs. While there may not be a perfect one-size-fits-all, providers should consider the potentially harmful effects as they could contribute to treatment complications and significantly impact the surviving years.