Oral health among children attending an oncology clinic in Trinidad

Abstract

ObjectivesLittle is known about the oral health of paediatric oncology patients in the Caribbean. Poor oral health can complicate oncology treatment, negatively affecting a child's health. In children undergoing chemotherapy or bone marrow transplant, odontogenic infections can progress to life‐threatening sepsis. The aim of this study is to investigate the oral health among children attending an oncology clinic in Trinidad.Material and MethodsSample population included paediatric oncology patients attending a children's hospital in Trinidad. Subsequent to obtaining informed consent, a 14‐item questionnaire was administered to parents/caregivers. An intra‐oral examination was undertaken by two dentists to assess soft tissues, gingival health, and dentition status, using visual examination only.ResultsSeventy‐one children and their caregivers participated in the study. The children consisted of both patients warded or attending as outpatients; 53.5% of patients were male and the mean age 6.64 (SD 3.33) years with a range of 1 to 15 years. Gingivitis and mucositis were present among 41.3% and 3% of patients, respectively. The prevalence of visible dental caries was 54.3%. Caries experience (dmft) was 2.28 (SD 3.63), and for those children with some caries experience (dmft > 0), this was 5.59 (SD 3.72). The majority (62.5%) had never visited a dentist. The most common dental treatment needs were dental prophylaxis (98.4%) and restorative treatment (50.8%). Acute lymphocytic leukaemia (39.1%) was the most common malignancy among this sample, and patients were at varying stages of cancer treatment.ConclusionsOral health among this sample of paediatric oncology patients was generally poor, with untreated caries being common, and the majority of children not having had any previous dental care. Preventive dental care for these patients should include oral hygiene instruction, dietary advice, topical fluoride application along with management of carious lesions, and odontogenic infections. This preliminary study highlights the need for closer collaboration between general dental practitioners, paediatric dentists, and paediatric oncology physicians, in caring for these patients.

Panorama das manifestações bucais decorrente do tratamento do câncer infantil: Uma revisão integrativa

“…Analisando os artigos incluídos, as lesões bucais agudas mais prevalentes em crianças durante o tratamento foi a mucosite, ulcerações, sangramento espontâneo e candidíase. Lesões essas dolorosas, porém já estabelecidas na literatura cientifica (Juarez-Lopez et al, 2018;Kowlessar et al, 2019;Lucena, Damascena, Ribeiro, Lima-Filho, & Valenca, 2019), para o manejo da mucosite, o cirurgião dentista pode ajudar no tratamento, que pode ser dividida em: suporte nutricional, controle da dor, descontaminação oral, paliação da boca seca, gerenciamento de sangramento oral e intervenções terapêuticas (Lalla, Sonis, & Peterson, 2008). Outra alteração também observada nos artigos foi a presença da xerostomia, perda do paladar e hipossalivação (Jalali et al, 2012;Lucena et al, 2019, Velten, Zandonade, & Monteiro de Barros Miotto, 2017.…”

Oral Equilibrium in Cachexia

“…[ 10 ] Persistent infection of periodontal tissues and dental pulp, oral mucosal ulcerations, lymphadenopathy, petechiae, taste dysfunction, and high prevalence of neglected dental caries significantly have a negative impact on the nutritional status of such cachexic patients ultimately increasing the risk of death. [ 38 ] Occasionally, the development of oral ulcerations was found to be associated with the administration of the drug-methotrexate. [ 36 ] Often, immunocompromised patients are prone to infections such as herpes simplex virus which follows an atypical course.…”

“…[ 36 ] Often, immunocompromised patients are prone to infections such as herpes simplex virus which follows an atypical course. [ 38 ] However, the occurrence of candidiasis and xerostomia as a result of aggressive chemotherapeutic regimens is shown to have a low incidence in pediatric cachexic patients. [ 36 ] Parents should encourage proper oral hygiene practices such as supervision of brushing using soft-bristled toothbrushes to prevent plaque accumulation, frequent replacement of toothbrushes as it may get colonized with oral bacteria and use of an alternate toothpaste in case of oral mucosal ulcerations.…”

“…[ 37 ] In addition, periodic dental check-up, dietary advice, topical fluoride applications, management of dental caries, will help in establishing an adequate dentitional status required to improve the quality of life of cachexic patients. [ 38 39 ]…”

Strategies for the dentist management of cancer patients: narrative literature review

“…5,6 Consequently, these sources of infections need to be treated or at least controlled before the patient is placed on antineoplastic therapy since the complications generated thereby can imply an increase in morbidity, mortality, and hospitalization costs. 4,7,8 Thus, the objective of this article is to present the dental procedures necessary for the prevention, diagnosis, and treatment of oral toxicities of cancer treatment.…”