Palliative oral care in patients undergoing radiotherapy: Integrated review

Sen, Suman; Priyadarshini, Sushree Bibhuprada B.; Sahoo, Pradyumna Kumar; Dutta, Abhijit; Singh, Ajit Kumar; Kumar, U. Ujwal

doi:10.4103/jfmpc.jfmpc_827_20

Cited by 6 publications

(11 citation statements)

References 19 publications

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“…Radiotherapy combined, or not, with surgery and/or chemotherapy in order to treat head and neck cancers is possible [1,2]. Aforementioned, this therapy uses corpuscular or electromagnetic ionizing radiation that inhibits or undermines tumor cells [1]; however, this non-selective radiation may harm healthy cells and lead to systemic and oral detrimental effects [1,7]. Damage to salivary glands and mucositis have already been observed among patients who have received doses between 20 -30 Gy [8,9].…”

Section: Resultsmentioning

confidence: 99%

“…Head and neck radiotherapy may lead to both intense and tardily oral manifestations. Commonly observed, mucositis appears to be the most frequent acute effect after seven days [of treatment] [6,9]; in spite of, its intensity, duration, and chronology have been related to irradiation parameters and/or the cytotoxicity of drugs (in cases of combined chemotherapy) [7,9]. The irradiation causes cell death, inhibits the tissue recovery, and totally or partially exposes the oral mucosa [1,7]; in addition, multiple ulcerated fibrinous lesions covered by pseudomembranes, erythema, edema, pain, dysphagia, and nutrition deficiency might be observed [5,7].…”

Section: Resultsmentioning

confidence: 99%

“…Moreover, exposure to radiation doses between 40 to 65 Gy drives to inflammation and consequently atrophy of salivary glands. Therefore, reduction of salivary flow may result in xerostomia (dry mouth sensation), labial commissures fissures, lip dryness, and dysgeusia (taste alteration) [1,3,6,7]. Furthermore, radiation caries (secondary caries) may occur from three weeks up to one year [2].…”

Section: Resultsmentioning

confidence: 99%

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Oral complications of head and neck radiotherapy: the importance of the dental surgeon

QUARESMA,

MATEUS,

PEDREIRA

et al. 2023

RGO, Rev. Gaúch. Odontol.

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Objective: radiotherapy can lead to different adverse effects in the oral epithelial cells. This article aimed to address the main oral manifestations associated with radiotherapy of head and neck neoplasms, highlighting the importance of the dental practitioners’ participation within the skilled multidisciplinary personnel to treatment. Methods: Research was conducted in the PubMed, Lilacs, SciELO, and Google Scholar databases using the keywords “head and neck radiotherapy”, “oral manifestations’’, and “head and neck neoplasm”. Eighteen out of 533 articles published between 2015 and 2022 were selected after duplicates removal and eligibility criteria application. Results: xerostomia, hyposalivation, trismus, dysgeusia, dysphagia, dentin hypersensitivity, fungal and viral infections, radiation caries, osteoradionecrosis, mucositis, periodontal alterations, and tooth development abnormalities were the most frequently reported oral effects of radiotherapy. Conclusions: The participation of dentists in the multidisciplinary team that treats patients with head and neck cancers is fundamental since several oral complications of radiotherapy are observed. Dentists can prevent, reduce and treat some detrimental effects whether the patient is followed-up since the beginning of radiotherapy.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Oral complications of head and neck radiotherapy: the importance of the dental surgeon

QUARESMA,

MATEUS,

PEDREIRA

et al. 2023

RGO, Rev. Gaúch. Odontol.

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“…A xerostomia está diretamente ligada aos cuidados paliativos devido à prevalência nestes pacientes de neoplasias em Research, Society and Development, v. 10, n. 9, e52410918356, 2021 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v10i9.18356 regiões de cabeça e pescoço que carecem de tratamentos com radiação, ou em outros sítios do organismo que podem requerer tratamento quimioterápico que pode ocasionar muitos efeitos adversos. No caso de radioterapia em região de cabeça e pescoço, o mecanismo da hipossalivação e consequente xerostomia, ocorre já que o componente parenquimatoso das glândulas salivares é altamente sensível a radiação, a glândula torna-se fibrótica, reduzindo a microcirculação e ocorre uma degradação parenquimatosa, diminuindo então, o fluxo salivar (Sen, et. al 2020).…”

Section: Discussionunclassified

Implicações clínicas orais e a importância dos cuidados odontológicos em pacientes sob cuidados paliativos: Revisão integrativa da literatura

Lima

Andalécio

Andrade

et al. 2021

RSD

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O objetivo deste artigo é caracterizar as implicações clínicas orais e a potencial contribuição da Odontologia para a qualidade de vida de pessoas em cuidados paliativos. Foram pesquisados artigos dos últimos 10 anos, relacionados ao assunto nas bases de dados PUBMED e Scielo com as palavras-chave: “cuidados paliativos”, “cuidado dental” e “saúde bucal” e no inglês “palliative care”, “dental care” ou “oral health”. Foram selecionados 7 artigos a partir da busca sistematizada e com a aplicação dos critérios de inclusão e exclusão. As principais manifestações orais de pacientes em cuidados paliativos são a xerostomia, a cárie dental, a candidose e a mucosite, e a presença do cirurgião dentista parece contribuir para a manutenção da qualidade de vida em níveis aceitáveis, ainda que as pessoas estejam em processo de morte. Percebe-se pelo exposto que a abordagem do cirurgião dentista é necessária no âmbito da promoção de saúde, prevenção de agravos e recuperação de reabilitação de danos, que possibilitam a manutenção da qualidade de vida e que esta atenção ainda é negligenciada, devido a falta de obrigatoriedade do cirurgião dentista nas linhas de cuidado de pacientes terminais. Mais estudos sobre a influência dos cuidados odontológicos na manutenção da qualidade de vida em pacientes sob cuidados paliativos são necessários para fomentar e ratificar a importância do cirurgião dentista na equipe de cuidados integrais em saúde desse público.

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“…7 In people receiving palliative care, the prevalence of dry mouth increases due to polypharmacy, radiotherapy, and systemic conditions. [8][9][10][11] Prevalence of dry mouth in palliative populations varies greatly depending on which measures are used but several studies rate perceived dryness at over 70%. 3,7,12 In terms of prevalence, the National Institute for Health and Care Excellence (NICE) guidelines suggest a level as high as 88% in the terminally ill 13 and a more recent review article 14 reports that the level of xerostomia in end-of-life patients varied from 64-92%.…”

Section: Introductionmentioning

confidence: 99%

Xerostomia: A silent burden for people receiving palliative care – A qualitative descriptive study.

Dourieu,

Lisiecka,

Evans

et al. 2024

Preprint

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Background The prevalence of dry mouth in the palliative care population is well documented and increases due to polypharmacy, radiotherapy and systemic conditions. Saliva as a lubricant for the mouth and throat has implications for swallowing, chewing, and speech. The literature about the experience of xerostomia (perceived feeling of dry mouth) in palliative care is scarce. Clinical evidence suggests that xerostomia has a negative impact on people’s comfort, however, no recent studies explored this impact in detail. This new knowledge is paramount to adhere to the principles of palliative care. Aims To evaluate the impact of xerostomia on the lives of people receiving palliative care with particular reference to eating and speaking. Design A qualitative descriptive study (interview design). Thematic analysis was used for data analysis. Setting A single specialist palliative care centre in Ireland. Results The majority of participants (35/40) had cancer. Xerostomia was reported to have multiple physical, psychological, and daily life consequences. Participants provided insights into the impact of xerostomia on sleeping, eating, talking, denture wearing, and they described in detail their intra-oral sensations associated with xerostomia. The negative effect of xerostomia on speech was reported as the most significant to participants. Conclusion Xerostomia has a profound impact on the daily lives of people receiving palliative care, including physical and psychological consequences. Speaking is often affected, which can impede the person’s ability to communicate. There needs to be increased awareness of the impact of xerostomia and more research is required to understand how best to manage xerostomia in a palliative care setting.

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Palliative oral care in patients undergoing radiotherapy: Integrated review

Cited by 6 publications

References 19 publications

Oral complications of head and neck radiotherapy: the importance of the dental surgeon

Oral complications of head and neck radiotherapy: the importance of the dental surgeon

Implicações clínicas orais e a importância dos cuidados odontológicos em pacientes sob cuidados paliativos: Revisão integrativa da literatura

Xerostomia: A silent burden for people receiving palliative care – A qualitative descriptive study.

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