Dental Approach in the Pediatric Oncology Patient: Characteristics of the Population Treated at the Dentistry Unit in a Pediatric Oncology Brazilian Teaching Hospital

Abstract

OBJECTIVES:The objective of this paper was to characterize the population seen at the dentistry unit of the hematology-oncology service of the Oncology-Hematology Service, Instituto da Criança at the Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo. Oral problems resulting from cancer therapy increase the risk of infection, length of hospital stay, treatment cost and negative impact on the course and prognosis of the disease.METHOD:Of the 367 medical records of cancer patients seen from November 2007 until December 2008: 186 with a cancer diagnosis and complete clinical data were selected, while 20 with a cancer diagnosis and incomplete records were excluded; 161 medical records with only hematological diagnosis were also excluded. The following characteristics were assessed: ethnicity, gender, age, diagnosis and characteristics of the neoplasm, cancer therapy status and performed dental procedures.RESULTS:Review of 1,236 visits indicated that 54% (n=100) of the patients had blood cancers, 46% (n=86) had solid tumors and 63% were undergoing anticancer therapy. The proportion of males (52.7%) in the study population was slightly greater. The most common cancer was acute lymphocytic leukemia (32.2%). Cancer occurred more often among those patients aged 5 to 9 years. The most common dental procedures were restorative treatment, preventive treatment and removal of infectious foci.CONCLUSION:The characteristics of the studied population were similar to those of the general Brazilian and global populations, especially regarding gender and diagnosis distributions. The aim of implementation of the dentistry unit was to maintain good oral health and patients’ quality of life, which is critical to provide oral care and prevent future oral problems.

A prática da odontologia hospitalar no Brasil: uma revisão integrativa da literatura

“…As much as 17 (60.7%) [3][4][5][6][7]10,18,19,[21][22][23][26][27]29,33 studies were published between 2014 and 2017, 4 (14.3%) 2,16,30,32 in 2011, 3 (10.7%) 24,25,28 in 2010, 2 (7.1%) 17,20 in 2013, and 1 (3.6%) in 2008 and 1 in 2012. 15,31 Most of the studies were conducted in São Paulo state, with 7 (25%) 2,15,17,19,22,24,26 publications, followed by the states of Santa Catarina (n=4, 14.3%), 7,25,28,32 Paraná (n=3, 10.7%) 6,13,30 and Mato Grosso (n=2, 5.6%). 18,23 The states of Bahia, Goiás, Mato Grosso do Sul, Minas Gerais, Pará, Paraíba, Pernambuco, Piauí, Rio Grande do Norte and Rio Grande do Sul had 1 (2.8%) publication each, accounting to 28% of the sample.…”

“…In order to identify the scenario of hospital dentistry in Brazil through published studies, it was found that 6 (21.4%) [13][14][15]17,23,26 studies had a control group; 17 (60.7%) [4][5][6]16,18,19,[20][21][22]24,[27][28][29][30][31][32][33] were related to patients' oral health profile and 5 (17.9%) 2,3,7,10,25 were questionnaire-based studies of which 4 3,7,10 involved only patients and 1 25 involved patients, caregivers and healthcare professionals.…”

“…Among the studies addressing the patients' oral health profile, 8 (47%) 4,6,22,24,27,29,30,32 were performed with patients admitted to conventional hospital beds, 6 (35.3%) 16,18,19,21,31,33 with ICU patients, 2 5,28 (11.8%) with patients admitted to ICUs and conventional hospital beds and 1 (5.9%) 20 did not mention. Twelve (70%) [4][5][6]16,18,19,22,28,29,[31][32][33] of the studies addressing the oral health profile were carried out with adult patients only, 2 hygiene kits while in hospital stays, how often daily they performed oral hygiene and whether it was done by the patients themselves or by their companions.…”

“…(11.8%) 24,27 with pediatric patients only, 1 (5.9%) 21 with patients of all ages and 2 (11.8%) 21,30 studies did not mention the age of patients. Regarding the type of approach to the patients, the following results were obtained: in 9 (52.9%) 4,16,19,21,27,28,[30][31][32] studies only oral examination was performed without any kind of intervention; in 1 (5.9%) 29 oral examination was performed followed by dental procedures if necessary and the patients received oral hygiene instructions; in 1 (5.9%) 6 study patients received oral examination and were referred for dental care if necessary; and 4 (23.6%) 4,5,20,22 studies did not mention the therapeutic approach.…”

“…In this integrative literature review, 46.4% of the studies were carried out with ICU patients having a dentist acting on the prevention and treatment of oral infections, especially those associated with VAP. [13][14][15][16][17][18][19][20][21][22][23][24] In the studies with a control group, although patients' oral hygiene was performed by the nursing team, dentists were responsible for providing oral care guidance, which led, in some cases, to a significant reduction in the mean hospital stay under mechanical ventilation 14 and to a reduction of primary sources of infection in the mouth 15 compared with the study groups in which preventive and curative measures were implemented in addition to oral care not supervised by dentists. The presence of the dentist resulted in benefits for these inpatients and possibly for the hospitals by reducing the hospitalization time of these individuals.…”