Oral health as a predictive factor for oral mucositis

Abstract

OBJECTIVES:Oral mucositis is a complication frequently associated with hematopoietic stem cell transplantation, decreasing a patient's quality of life and increasing the occurrence of opportunistic infections. The purpose of this study was to determine the incidence and severity of oral mucositis and to assess the correlation of this disease with the oral health of an individual at the time of hematopoietic stem cell transplantation.METHODS:Before transplantation, patients' oral health and inflammatory conditions were determined using the gingival index and the plaque index, which are based on gingival bleeding and the presence of dental plaque, respectively. Additionally, the dental health status was determined using the decayed, missing, and filled teeth index. The monitoring of oral mucositis was based on the World Health Organization grading system and was performed for five periods: from Day 0 to D+5, from D+6 to D+10, from D+11 to D+15, from D+16 to D+20, and from D+21 to D+30.RESULTS:A total of 97 patients (56% male and 44% female) who underwent hematopoietic stem cell transplantation at the Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo between January 2008 and July 2009 were prospectively examined. The incidence of ulcerative mucositis was highest from days +6 to +10 and from days +11 to +15 in the patients who underwent autologous and allogeneic hematopoietic stem cell transplantation, respectively.CONCLUSION:The data, including the dental plaque and periodontal status data, showed that these oral health factors were predictive of the incidence and severity of oral mucositis in a cohort of patients with similar conditioning regimens before hematopoietic stem cell transplantation.

Periodontal status of candidates for allogeneic hematopoietic stem cell transplantation

“…Several authors have investigated possible associations of oral health condition prior to transplantation with the incidence and severity of complications in the immediate post-transplant period. 2,[8][9][10][11][12][13][14][15][16][17] Among the oral diseases described in candidates for HSCT, periodontal diseases, mainly gingivitis and periodontitis, are the most frequent 18 and most often associated with sepsis. 3,19 The periodontal diseases present a wide heterogeneity in extent, severity, progress, and treatment response.…”

“…The mouth is a frequent site of local infections and an important port of entry for systemic infections in HSCT recipients. Several authors have investigated possible associations of oral health condition prior to transplantation with the incidence and severity of complications in the immediate post‐transplant period . Among the oral diseases described in candidates for HSCT, periodontal diseases, mainly gingivitis and periodontitis, are the most frequent and most often associated with sepsis …”

Incidence of and risk factors for development of oral mucositis in outpatients undergoing cancer chemotherapy

“…In this context, an interdisciplinary approach (with the participation of nurses, physicians, dentists, dental hygienists, dieticians, pharmacists, and others as relevant) will prevent the development of OM and/or treat the condition (da Silva Santos et al, 2011;McGuire et al, 2013) have reported a decrease the time elapsed of OM in patients with OM receiving oral care before haematopoetic stem cell transplantation (da Silva Santos et al, 2011). In another study, it has been observed that oral care can reduce the severity and incidence of OM (Coracin et al, 2013). On the other hand, some reports have shown that oral problems are not adequately addressed in cancer patients undergoing chemotherapy, that these problems are inadequately treated due to being ignored by both doctors and nurses, and that there is a lack of nursing interventions for cancer patients who have oral mucositis (Araújo et al, 2015;Daniel, Damato, & Johnson, 2004;Honnor & Law, 2002).…”

Prevenção E Tratamento Das Mucosites Orais: Uma Revisão Sistemática

“…Cursa com ulcerações dolorosas recobertas por exsudato fibrinoso (pseudomembrana) de coloração esbranquiçada ou opalescente. Além da importante sintomatologia, as ulcerações aumentam o risco de infecção local e sistêmica, comprometem a função oral e interferem no tratamento antineoplásico, podendo levar à sua interrupção, o que compromete a sobrevida do paciente [10][11] . Compreendendo as sequelas causadas ao paciente acometido pela mucosite, percebe-se a grande relevância de uma terapia adequada para prevenir a sua ocorrência ou acelerar a sua resolução, o que traz benefício clínico significativo, bem como redução de custos na área de saúde 12 …”