Necessidade de cuidados paliativos odontológicos em crianças com doenças crônicas. Caracterização de amostra

Abstract

Carrillo CM. Need of oral palliative care in children with chronic illness. Sample characterization [Dissertation]. São Paulo: Faculdade de Medicina, Universidade de São Paulo; 2011. INTRODUCTION: Epidermolysis bullosa is a genetic chronic disease that affects the quality of life deeply, whose oral symptoms compromised the daily living activities as chewing, swallowing and teeth brushing.. Children with cancer may also have oral manifestations, but transient and usually do not affect the teeth. This study assessed the oral health and the need of oral care in children in palliative care with epidermolysis bullosa compared to children with cancer. METHODS: Twenty-four patients with epidermolysis bullosa (Group A) and 18 cancer patients (Group B) followed up at the Pain and Palliative Care Outpatient Clinic were studied. Clinical assessment included: clinical characteristics, assessment of orofacial pain, oral health, quality of life according to the activities of daily living and general health status. RESULTS: Face numbness, tooth mobility, taste disturbance and speech difficulties were observed only in group B. Difficult chewing, disfagia, gagging, dry lips, oral lesions were more frequent in group A compared to group B, with significant difference, p<0,0001, p<0,0001, p=0,002, p<0,0001 and p<0,0001, respectively. Group A had a greater difficulty opening mouth, number of decay teeth, prevalence of caries and disability regarding the CHAQ eating (III) and reach (VII) domains than group B, with significant difference, p< 0,0001, p=0,0004, p< 0,001, p<0,001, p=0,005 and p<0,0001, respectively. Both groups showed a significant general health impairment. CONCLUSIONS: Epidermolysis bullosa patients in palliative care had chronic oral blistering and ulcerations, due to disease, more frequently than cancer patients, which had oral mucositis as a side effect of the antineoplasic treatment. They also showed greater oral symptoms, poor oral health, greater open mouth limitation and poor quality of life than cancer patients.