A Novel Oncodental Collaborative Team: Integrating Expertise for Central Line–Associated Bloodstream Infection Prevention in Pediatric Oncology Patients

Abstract

PURPOSE: Pediatric oncology and bone marrow transplant patients are at high risk of infection, and limitations to dental expertise among medical providers render patients vulnerable to central line–associated bloodstream infections from oral pathogens. Traditionally, oral health maintenance relied on patients and bedside nurses; however, routine methods are often suboptimal to prevent central line–associated bloodstream infection in high-risk patients. Limited overlap of medical and dental expertise, and limited dental resources in typical oncology units, prevent optimal oral care for children with cancer, requiring novel solutions to better integrate specialties. METHODS: Here, we outline the creation of a novel Pediatric oncodental team to address oral-systemic infection prevention strategies for high-risk patients. RESULTS: Our oncology and dental teams created a systematic approach for increasing oral surveillance and treatment in select high-risk patients. Supervised pediatric dental residents participated in scheduled oncology rounds, and a permanent oral health educator with a background in dental hygiene was also hired as a dedicated dental professional within our oncology department. CONCLUSION: Our pediatric oncodental team aims to sustain optimal oral complication prevention strategies to reduce the risk of infection, provide education on the significance of the oral-systemic link in cancer care, and improve access and continuity of care.

Knowledge about Administration and Regulation of High Alert Medication among Nurses in Oncology Department

“…The majority of nurses had either a Post RN qualification (48.1%) or a BSN degree (42.1%), with varying levels of work experience, predominantly between 1 and 5 years (47.4%). This varied background suggests a diverse group of respondents, providing a comprehensive overview of the nursing knowledge landscape within the institution (14). A significant portion of the nurses displayed a lack of accurate knowledge in critical areas.…”

“…Participants were informed about the purpose of the study and assured of their anonymity and confidentiality. Written informed consent was obtained from all participants before their inclusion in the study (14). Data analysis was conducted using SPSS version 25.…”

Challenging gestational trophoblastic disease cases and mimics: An exemplar for the management of rare tumours

“…Such a strategy would acknowledge the challenges patients face in dealing with multidisciplinary cancer management which requires a degree of self-reliance, and where adverse events can occur when self-reliance is missing. [54,55] Navigating care without a compass can also increase psychological distress, worsening cancer outcomes. [56] A specialist centre would also help address the concerns highlighted by 25% of GTD patients in our centre who reported deficits in the understanding of their condition by medical professionals with whom they interacted outside the centre.…”

The Dental Oncology Complication that Wouldn’t go Away

“…Drug holidays have yet to be proven as definitively effective strategies to prevent MRONJ, their benefits are unclear, and the literature is divided. 2, 33,36 The foundation of a drug holiday is that despite the 11.2 year half-life oral bisphosphonate or 6 month half-life of denosumab, alongside oncology regimes for BMAs, effective drug holidays cannot be achieved. The bone marrow stem cells and osteoclast precursors do not have the ability to regenerate to sufficient numbers to remodel and renew bone during the healing phase.…”