Oral health and stomatological complications in pediatric cancer patients

Abstract

Objective: To assess oral health status and its relationship with stomatological complications, oral mucositis (OM) and odontogenic infections (OI), after dental work in pediatric patients with cancer. Design: Prospective cohort study and analysis of oral health conditions with a 6-month follow-up. Setting: Dental Unit, Stomatology Unit and Oncology Service, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Brazil. Participants: Sixty-five pediatric patients with cancer, 36 boys and 29 girls; aged 6 months to 18 years; 839 dental evaluations during oncologic treatment and comparisons between two patients groups - inappropriate oral health and appropriate oral health – considering the risk for stomatological complications manifesting as odontogenic infections and mucositis related to chemotherapy, gender, age group, head and neck radiation therapy and time to onset of complications Results: Thirty-three patients had inappropriate oral health. The group with appropriate oral health had lower dental infection rates (P = 0.003), and mucositis emerged later, compared with the inappropriate health group (P < 0.001). The data suggest that the group with inappropriate oral health had increased odontogenic infection rates, independently of the chemotherapeutic protocol adopted, when mucositis emerged earlier (when the patient presented hyperemic mucosa and burning sensation). Patients with deciduous teeth (6 months a 6 years) had lower incidence of mucositis (69.2%). Males had higher incidence of mucositis (80.6%). In the permanent dentition range (13-18 years) there was a higher incidence of dental infections (41.2%). Girls were more often associated with dental infections (41.4%). Conclusion: Studies on dental work in pediatric cancer patients are very limited. Our research contributed to clarify patient profile and needs. The results will be fundamental for the development of protocols and service strategies directed to this population. Educational measures alone do not reduce the risk of odontogenic infections.