Assessment of oral health status of children with Leukemia: A cross‐sectional study

Abstract

Aim The present study was conducted with an aim to assess the oral hygiene status, gingival health status, and prevalence of dental caries, oral mucositis and xerostomia among children with leukemia and compare it with healthy children. Methods and Results A total sample size of 220 children with 110 children with Leukemia of subtype acute lymphoblastic leukemia (ALL) undergoing treatment and 110 healthy children in the age group of 3‐14 years was selected. Evaluation of caries status using dmft/DMFT indices, oral hygiene status using OHI‐S and plaque index by Sillness and Loe, gingival health status using modified gingival index, oral mucositis as per WHO oral toxicity scale, xerostomia as per common terminology criteria for adverse events for dry mouth, and salivary pH using pH paper strips was done. Results revealed a lower prevalence of dental caries, good oral hygiene and mild gingivitis in children with ALL when compared to healthy children. Oral mucositis was found to occur only in children with ALL and a reduced salivary flow rate and reduced salivary pH were seen in these children when compared to healthy children. Conclusion It was concluded that children with ALL undergoing treatment and following an oral care protocol presented with a good Oral Health Status when compared with healthy children.

Unstimulated salivary flow and oral streptococci in pediatric patients with hematological tumors: A longitudinal study

“…Thus, this condition can result in a lack of proper oral hygiene during cancer treatment, favoring the accumulation of oral biofilm with a higher cariogenic bacterial load, which is widely associated with dental caries. 13,22 Overall, these findings have direct clinical implications because they demonstrate the importance of oral healthcare during cancer treatment, especially in long-term chemotherapy periods. These patients should be monitored daily by a specialized dental staff in conjunction with the pediatric oncology team at the beginning of diagnosing the disease to promote healthcare for children, and thereby avoid the delay in antineoplastic treatment.…”

“…35 Indeed, our preliminary study 14 and others 12,36 have shown that the induction phase is a critical time for hematological cancer treatment with more impact on oral physiological parameters such as saliva, oral microbiota, and host cell interactions. Although some previous studies have also evaluated these response variables (USF and oral streptococci load), the results are crosssectional 11,13,18 or longitudinal of short-term periods (50 days for the endpoint), 9,22,37,38 which are not able to completely evaluate the impact of cancer therapy on different follow-up time-points.…”

“…10,11 Salivary changes in children have consequently been associated with deteriorating oral health status during chemotherapy. 9,[12][13][14] However, some cross-sectional studies 15,16 have shown controversial results regarding chemotherapy's effect on the salivary flow rate because the saliva exams were performed in different early stages of cancer treatment. Moreover, stimulated saliva has been commonly used, 17,18,19,20 but the method applied to stimulate salivation can overestimate the saliva flow results and is not indicated for understanding the specific effect of chemotherapy under clinical saliva parameters.…”

“…Moreover, stimulated saliva has been commonly used, 17,18,19,20 but the method applied to stimulate salivation can overestimate the saliva flow results and is not indicated for understanding the specific effect of chemotherapy under clinical saliva parameters. 10,13,21 Thus, unstimulated saliva flow (USF) rate has been recommended for oncology research and the long-term effect of chemotherapy under this salivary parameter of pediatric patients remains unknown.…”

Salivary Test Assessment in an Oncohematological Pediatric Sample: A Case Control Study

“…In another survey conducted in 2010 by Ponce-Torres et al, the prevalence of oral manifestations observed in these children was gingivitis, decay, mucositis, cheilitis, periodontitis, recurrent herpes, primary herpetic gingivostomatitis, xerostomia, mucosal pallor, ecchymoses and induced ulcers [17]. In a study by Kapoor et al [18], mean unstimulated salivary flow rate and mean salivary pH scores were found to be lower in the group of children with leukemia and were higher in the group of healthy children. Several authors have reported similar findings [15,[19][20][21].…”