Dental Management of Patients Receiving Chemotherapy

Lockhart, Peter B.

doi:10.1007/978-1-4613-3912-0_7

Cited by 5 publications

(3 citation statements)

References 28 publications

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“…Many cytostatic drugs, including methotrexate, doxorubicin, and 5-fluorouracil, have a direct toxic effect on rapidly dividing oral mucosal cells, resulting in inflammation and epithelial damage (noninfectious mucositis). Consequently, the damaged mucosal epithelium may become infected: local defense mechanisms are impaired, and there may be alterations in the flow rate and the composition of saliva [2]. Furthermore, many chemotherapeutic regimens used to treat cancer are myelosuppressive and/or immunosuppressive, increasing the patient's susceptibility to bacterial, viral or fungal infection.…”

Section: Introductionmentioning

confidence: 98%

Oral mucositis in patients treated with chemotherapy for solid tumors: a retrospective analysis of 150 cases

Raber-Durlacher

Weijl

Saris

et al. 2000

Support Care Cancer

102

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The incidence and the severity of chemotherapy-associated oral mucositis were determined in a retrospective analysis of 150 patients with various solid tumors. In addition, possible risk factors for the development of mucositis were identified. Patients were treated with chemotherapeutic regimens appropriate to tumor type and disease stage on an in- or outpatient basis. Mucositis was scored using the World Health Organization (WHO) criteria. Eighty-seven episodes of mucositis occurred in 47 (31%) patients. Twenty-six patients each experienced only one episode, whereas 21 patients had up to eight episodes of mucositis. The 1,281 chemotherapy cycles that have been analyzed included 87 cycles in which mucositis was observed. In 16 patients (11%) only slight oral mucosal changes were recorded (maximum WHO score 1), while 25 patients (17%) experienced mild to moderate mucositis (maximum WHO score 2), and in 6 patients (4%) mucositis was moderate to severe (maximum WHO score 3). No grade 4 mucositis developed. In 24 of the 47 patients with mucositis (51%) clinical features of acute pseudomembranous candidiasis were present. Leukopenia, leukopenic fever, and use of corticosteroids and central venous catheters were associated with the chemotherapy cycles with mucositis. Multivariate analysis identified the administration of paclitaxel, doxorubicin, or etoposide as independent risk factor (adjusted rate ratios 8.06, 7.35, and 6.70, respectively), whereas low body mass was associated with a slightly increased risk (adjusted rate ratio 0.92) for the development of mucositis. In conclusion, almost one-third of patients receiving chemotherapy for solid tumors experienced one or more episodes of mild to more severe oral mucositis, indicating that this is a frequent complication in such patients.

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Section: Introductionmentioning

confidence: 98%

Oral mucositis in patients treated with chemotherapy for solid tumors: a retrospective analysis of 150 cases

Raber-Durlacher

Weijl

Saris

et al. 2000

Support Care Cancer

102

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“…Indirect oral reactions have several clinical presentations (Table 12). Most result from myelosuppression which is most pronounced 2 weeks after administration of the chemotherapeutic agent (30). Neutropenia, thrombocytopenia, and anemia predispose patients to certain oral complications.…”

Section: Stomatotoxic Medicationsmentioning

confidence: 99%

“…Meticulous hand washing by hospital personnel, appropriate cleansing of the patient's living area and instrumentation, and avoidance of raw foods and flowers can all reduce pathogenic exposure. Other measures such as nystatin swish and swallow, fluoride rinses, artificial saliva, and a soft, bland diet may help reduce the risk of oral complications (30).…”

Section: Stomatotoxic Medicationsmentioning

confidence: 99%

Oral drug reactions

Tack

Rogers

2002

Dermatol Ther

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Drug‐induced side effects are a frequent occurrence. Many commonly available drugs are capable of causing untoward reactions. Such adverse effects may be seen in all age groups and present in many different forms. The oral drug reactions are often nonspecific, but they may mimic specific disease states such as pemphigus, erythema multiforme, or lichen planus. In such cases a high index of suspicion is required to make a correct diagnosis.

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