Dental Decay Due to Xerostomia and Nystatin

Phillips, Scott M.; Dellinger, Tracy

doi:10.1345/aph.1g016

Cited by 4 publications

(3 citation statements)

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“…It should be noted that the use of amphotericin B lozenges did not perform as well as systemic fluconazole in this comparative study . Some products, including oral rinse forms of nystatin that contain sugar, leads to increased caries risk particularly in dentate patients with hyposalivation . Topical fluconazole rinses can be compounded and have been examined and shown effective in cancer patients with candidiasis.…”

Section: Introductionmentioning

confidence: 80%

Common oral complications of head and neck cancer radiation therapy: mucositis, infections, saliva change, fibrosis, sensory dysfunctions, dental caries, periodontal disease, and osteoradionecrosis

et al. 2017

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Patients undergoing radiation therapy for the head and neck are susceptible to a significant and often abrupt deterioration in their oral health. The oral morbidities of radiation therapy include but are not limited to an increased susceptibility to dental caries and periodontal disease. They also include profound and often permanent functional and sensory changes involving the oral soft tissue. These changes range from oral mucositis experienced during and soon after treatment, mucosal opportunistic infections, neurosensory disorders, and tissue fibrosis. Many of the oral soft tissue changes following radiation therapy are difficult challenges to the patients and their caregivers and require life‐long strategies to alleviate their deleterious effect on basic life functions and on the quality of life. We discuss the presentation, prognosis, and management strategies of the dental structure and oral soft tissue morbidities resulting from the administration of therapeutic radiation in head and neck patient. A case for a collaborative and integrated multidisciplinary approach to the management of these patients is made, with specific recommendation to include knowledgeable and experienced oral health care professionals in the treatment team.

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Section: Introductionmentioning

confidence: 80%

Common oral complications of head and neck cancer radiation therapy: mucositis, infections, saliva change, fibrosis, sensory dysfunctions, dental caries, periodontal disease, and osteoradionecrosis

et al. 2017

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“…The agents are nystatin and amphotericin B (Europe) [19], applied five to six times daily. Some products, including oral rinse forms of nystatin, are highly sugar sweetened, leading to increased caries risk, particularly in the patients with hyposalivation [24,34]. A number of topical azoles are available (Table 2).…”

Section: Approach To Managementmentioning

confidence: 99%

Oropharyngeal candidiasis in head and neck cancer patients treated with radiation: update 2011

Bensadoun

Patton

Lalla

et al. 2011

Support Care Cancer

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Diagnosis and management of OPC is required in head and neck cancer patients treated with radiation. Local therapy is suggested as first-line treatment for OPC, unless severe clinical infection or high risk immune suppression necessitate systemic therapy. The availability of effective locally delivered (topical) medications may provide potential for prophylaxis for carriers of Candida species in head and cancer patients during radiation therapy.

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“…Biofilm offers effective protection against antimicrobials to which planktonic organisms are usually susceptible. In addition, drawbacks of the prolonged general use of daily oral antifungal lozenges or rinses are poor patient compliance, possible cariogenic activity [29], drug-specific side effects and eventual drug resistance with generation of persister cells and colonies [26]. Therefore, based on the available evidence to date, clinical practice guidelines state that the most effective treatment of persistent Candida biofilms on VPs is removal and replacement of the medical device [28].…”

Section: Discussionmentioning

confidence: 99%

Biofilm on the tracheoesophageal voice prosthesis: considerations for oral decontamination

Somogyi-Ganss

Chambers

Lewin

et al. 2016

Eur Arch Otorhinolaryngol

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Objectives The tracheoesophageal puncture (TEP) restores verbal communication after total laryngectomy using a one-way valved voice prosthesis (VP). Microbial colonization can shorten VP device life. Our aims were to investigate patterns of prosthetic and oral colonization, and record changes in VP device life after targeted decontamination. Materials and Methods We conducted a retrospective review of TEP clinic patients who underwent microbial analysis of the VP between 01/2003 and 07/2013. Two subgroups were analyzed: 1) patients with microbial analysis of the VP and the mouth were analyzed to identify patterns of common contamination, and 2) patients who were prescribed targeted oral decontamination on the basis of the microbial analysis of the VP were analyzed to evaluate effects on device life. Results Among 42 patients, 3 patients had only fungal, 5 only bacterial, and 33 had polyspecies fungal and bacterial colonization. In the TEP-oral microflora subgroup (n=15), 7 had common microorganisms in the mouth and on the VP. Among the decontamination subgroup (n=23), 6 patients received broad spectrum rinse, 16 antifungal agents and 13 antibiotics, or a combination thereof. After targeted decontamination, the median device life of prostheses improved from 7.89 to 10.82 weeks (p=0.260). Conclusion The majority of patients with a suboptimal VP device life in this pilot had polyspecies bacterial and fungal colonization. VPs rarely had fungal contamination alone (3%), and non-albicans fungal species were more common than expected. For these reasons, we are exploring the use of targeted decontamination regimens that were associated with 1.4-fold improvement in VP duration.

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Dental Decay Due to Xerostomia and Nystatin

Cited by 4 publications

References 0 publications

Common oral complications of head and neck cancer radiation therapy: mucositis, infections, saliva change, fibrosis, sensory dysfunctions, dental caries, periodontal disease, and osteoradionecrosis

Common oral complications of head and neck cancer radiation therapy: mucositis, infections, saliva change, fibrosis, sensory dysfunctions, dental caries, periodontal disease, and osteoradionecrosis

Oropharyngeal candidiasis in head and neck cancer patients treated with radiation: update 2011

Biofilm on the tracheoesophageal voice prosthesis: considerations for oral decontamination

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