Prevention and Treatment of Oral Complications in Hematologic Childhood Cancer Patients: An Update

Abstract

Cancers have a highly negative impact on the quality of life of paediatric patients and require an individualised oral treatment program for the phases of the disease. The aim of this study was to update existing research on oral care in children diagnosed with cancer. We carried out a literature search (in English, Spanish and Portuguese) in the Pubmed, Cochrane Library, EBSCO, WOS, SciELO, Lilacs, ProQuest, and SCOPUS databases and the websites of hospitals that treat childhood cancers. We found 114 articles and two hospital protocols. After review, we describe the interventions necessary to maintain oral health in children with cancer, divided into: phase I, before initiation of cancer treatment (review of medical record and oral history, planning of preventive strategies and dental treatments); phase II, from initiation of chemo-radiotherapy to 30–45 days post-therapy (maintenance of oral hygiene, reinforcement of parent/patient education in oral care, prevention and treatment of complications derived from cancer treatment); phase III, from 1 year to lifetime (periodic check-ups, maintenance, and reinforcement of oral hygiene, dental treatments, symptomatic care of the effects of long-term cancer treatment). The use of standardised protocols can avoid or minimise oral cancer complications and the side effects of cancer therapies.

Oral Manifestations: A Warning-Sign in Children with Hematological Disease Acute Lymphocytic Leukemia

“… To educate patients and parents about the importance of optimal oral care to minimize oral problems and discomfort before, during and after cancer treatment. To advise patients/parents about the possible short- and long-term side effects of cancer treatment in the oral cavity and craniofacial complex [ 65 , 66 ]. …”

“…To advise patients/parents about the possible short- and long-term side effects of cancer treatment in the oral cavity and craniofacial complex [ 65 , 66 ].…”

“…Successful management of oral complications, including systemic infections of oral origin, should begin with the oral examination, the introduction of comprehensive oral hygiene measures and definitive dental interventions prior to initiation of cancer therapy. The incorporation of a pediatric dentist in the multidisciplinary team in childhood cancer, and the establishment of standardized protocols based on prevention, and not just the treatment of the complications is, accordingly, necessary in order to ensure successful cancer treatment and the best quality of life [ 65 ].…”

Manual de cuidados orales para pacientes pediátricos con cáncer

“…De ser posible, sugerir el uso de radiografías digitales que reducen la exposición del paciente. Si es necesario, se pueden solicitar radiografías panorámicas, aleta de mordida (bite-wing) y periapicales (62,(71)(72)(73).…”