The efficacy of two different oral hygiene regimens on the incidence and severity of oral mucositis in pediatric patients receiving hematopoietic stem cell transplantation: A prospective interventional study

Abstract

Aims This prospective interventional study aimed to assess the efficacy of supersaturated calcium phosphate rinse and the use of an extra‐soft toothbrush twice a day when added to the existing oral hygiene protocol regimen (0.12% chlorhexidine gluconate + 3% sodium bicarbonate + nystatin 5000 U/mL) in reducing the severity of oral mucositis among pediatric patients receiving chemotherapy for the hematopoietic stem cell transplant. Methods Forty‐five patients that received chemotherapy for the hematopoietic stem cell transplant were randomly allocated to three groups of 15 patients each. Group A was advised to follow the existing oral hygiene protocol regimen (Control), group B was advised to brush their teeth twice daily using an extra‐soft toothbrush and to follow the control regimen, and lastly group C was advised to use supersaturated calcium phosphate rinse and to follow the control regimen. Oral mucositis was recorded according to World Health Organization criteria from the day of admission (day 1) to the day of discharge (day 28). The incidence of oral mucositis between the three groups was compared using the Kruskall‐Wallis test while the severity of oral mucositis between the three groups was compared using a one‐way ANOVA test. Results The results of the study showed no significant difference in the incidence of oral mucositis between the three groups; however, there was a lower severity of oral mucositis in the supersaturated calcium phosphate rinse group when compared to the control group or the group who used an extra‐soft toothbrush with the control regimen. Conclusion Although marginally fewer cases and lower severity of oral mucositis was observed in the group using supersaturated calcium phosphate rinse, the lack of statistical significance suggests that the evidence for their use is not conclusive. The results of this study also showed that the introduction of an extra‐soft toothbrush into the oral hygiene regimen did not significantly reduce the incidence of oral mucositis and may actually be responsible for an increase in the severity of oral mucositis.

Oral mucositis in paediatric cancer patients undergoing allogeneic hematopoietic stem cell transplantation preventively treated with professional dental care and photobiomodulation: Incidence and risk factors

“…A systematic review and meta‐analysis revealed a negative result, wherein a decrease in the incidence of OM after performing PBM as prophylactic treatment and a reduction in the severity of OM were observed 33 . The incidence of OM in studies without prophylactic PBM protocol was higher (80%‐91.7%) than that in our results (73.5%) 19,20 . The conflicting results may reflect the methodological and protocol diversity between the studies.…”

“…Considering the available sample size of 49 HSCT paediatric patients and a prevalence of OM of 71%‐91.7%, 2‐5,19,20 the study had 80% power to demonstrate an absolute difference in the occurrence of OM between exposed and unexposed patients, with an alpha error of 5%.…”

A prospective interventional study of recombinant human interleukin-11 mouthwash in chemotherapy-induced oral mucositis

“…Basic oral care is considered the backbone of supportive care for patients receiving cancer treatment, which could reduce the incidence of moderate to severe OM [4,8]. At present, mixed medication mouthwashes, which include antibacterial drugs, analgesics, vitamin B12, Xilei powder and hormone therapy, are widely used clinically [9,10].…”

Prevalence and risk factors of oral mucositis in paediatric patients undergoing haematopoietic stem cell transplantation

“…Mucositis, or mucosal barrier injury, is a condition needing supportive care characterised by erythema, atrophy and ulceration of mucous membrane anywhere along the alimentary tract as a result of cancer therapy (Sonis, 2004 ). Oral mucositis (OM) is frequently occurring treatment‐induced side effect in patients with oncological and haematological disorders (Berger et al., 2018 ; Abed et al., 2019 ; Mubaraki et al., 2020 ). Haematopoietic stem cell transplantation (HSCT) is the treatment of choice for various malignancies, immune deficiencies and bone marrow failure syndromes in children, adolescents and adults (Barriga et al., 2012 ; Copelan, 2006 ).…”