Oral mucosal changes induced by adjuvant endocrine therapies in breast cancer patients: clinical aspects and proposal for management

Original Research: Oral Health Concerns of Female Breast Cancer Survivors on Adjuvant Endocrine Therapy

BACKGROUND

Oral complications from cancer treatments are among the adverse effects breast cancer survivors can face. Yet such complications are often overlooked in cancer survivorship care. Many breast cancer survivors are receiving adjuvant endocrine therapy, but there is limited understanding of potential oral complications from this therapy.

PURPOSE

This study aimed to compare aspects of oral health in female breast cancer survivors who were taking adjuvant endocrine therapy with those of survivors not taking such therapy.

METHODS

National Health and Nutrition Examination Survey data collected from January 2009 through March 2020 were used for the analysis. Female adults ages 20 years and older who had been diagnosed with breast cancer were included. Linear regression and χ 2 analyses were conducted to examine aspects of oral health, using IBM SPSS Complex Samples software, version 27.

RESULTS

In our sample of 423 female breast cancer survivors, 7.1% were taking tamoxifen, 7.8% were taking anastrozole, 4.3% were taking letrozole, and 2.9% were taking exemestane. Compared with the survivors not taking such therapy, a greater proportion of those taking it had decayed teeth, gum disease/problems, and were recommended for imminent dental care after oral health examination by dentists. The survivors who were not taking adjuvant endocrine therapy had more coronal cavities.

CONCLUSIONS

Data analysis showed that female breast cancer survivors taking adjuvant endocrine therapy appear more likely to have oral health issues than those not taking such therapy. Improved awareness of these issues is critical. Assessment and management guidelines to address these oral health issues are needed by health care providers.

Association between breastfeeding and periodontitis in Korean women using Korea National Health and Nutrition Examination Survey (KNHANES): a cross-sectional study

OBJECTIVES

The effect of breastfeeding on periodontal disease in women remains unclear. This cross-sectional study used data from the Korean National Health and Nutrition Examination Survey to explore the association between breastfeeding and periodontitis in Korean women using data from the Korean National Health and Nutrition Examination Survey (KNHANES VII).

MATERIALS AND METHODS

Cross-sectional data was analyzed from the KNHANES 2016-2018. The study population included 5,587 parous women aged ≥ 30 years. The outcome variable was the presence or absence of periodontitis. The explanatory variable, period of breastfeeding, was defined as "none", "1-11 months", and "more than 12 months". Confounder variables (socio-educational, personal healthcare practice, and systemic medical characteristics) were adjusted for in the logistic regression analysis.

RESULTS

Approximately 60% of the participants breastfed for ≥ 12 months. In all statistical models, the prevalence of periodontitis was approximately 60% greater in women that did not breastfeed compared to women that had breastfed for 12 months or longer. When adjusted for age, statistical significance was only present in the 50-59 years age group (adjusted odds ratio [aOR], 1.678; 95% confidence interval [CIs], 1.046-2.691).

CONCLUSION

Our study shows that women that breastfed for a relatively long duration had a lower risk of periodontitis. Therefore, breastfeeding may be beneficial for women's periodontal health. These results are expected to be helpful in oral health education for pregnant women.

Association of medications with burning mouth syndrome in Taiwanese aged patients

Background/purpose

Burning mouth syndrome (BMS) occurs more frequently in middle-aged or elderly patients, especially the older female patients. It may relate to multiple medications in the older people. This study aimed to evaluate the association of polypharmacy with BMS.

Materials and methods

Eighty BMS patients aged from 45 to 80 years were recruited into this study, and their medical data, especially the medication records, were collected and analyzed to assess the association of polypharmacy with BMS.

Results

Of the 80 BMS patients, 14 did not take any medication, 38 took 1-4 medicines, 17 took 5-8 medicines, and 11 took ≥9 medicines. The mean number of medicines taken by each BMS patient is 4.49. For the 80 BMS patients, the mean number of medicines taken by each BMS patient was significantly higher in the older age group (7.00 ± 7.76; age ≥65 years; n = 31) than in the relatively younger age group (2.90 ± 2.95; age 45-64 years; n = 49) (P = 0.001). The similar result was also observed in the female BMS patients. We also found that psychotropics, gastroprotectors and gastrointestinal tract (GI)-associated drugs, and antihypertensives were the three most commonly used drugs in our 80 BMS patients. Among them, the relatively high frequencies of using anxiolytics and antidepressants in the psychotropics, and beta-blockers in the antihypertensives were observed.

Conclusion

Our findings suggest that multiple medications (polypharmacy) may play an important role in the development of BMS, especially for the older female BMS patients.

Oral Health-Related Quality of Life in Patients after Stroke-A Systematic Review

OBJECTIVES

Aim of this systematic review was to assess oral health-related quality of life (OHRQoL) of patients after stroke.

METHODS

The systematic literature search was performed on December 2021 based on PubMed, Medline, Web of Science, and Scopus, with the search terms: "oral health-related quality of life" AND stroke OR apoplexy OR ischemic stroke OR apoplectic insult. Articles exclusively examining patients after stroke and reporting a well-documented and valid OHRQoL measurement were included.

RESULTS

Out of 68 findings, 8 studies were included. The number of patients ranged between 31 and 549 individuals, mean age between 55.7 and 73.9 years, and 49-72% of individuals were male. Two studies included a healthy control group. Oral health parameters were rarely reported across studies. Five studies reported on the Oral Health Impact Profile (OHIP) 14 for OHRQoL, showing means between 2.87 and 33.0 in sum score. Three studies applied Geriatric Oral Assessment Index (GOHAI), with sum scores between 45.6 and 55.0. Only one study found worse OHRQoL in stroke patients compared to healthy controls. Two studies reported on an association between OHRQoL and general quality of life. Three studies found OHRQoL to be associated with different oral health parameters. Only one study found OHRQoL to be associated with stroke-related parameters.

CONCLUSIONS

Patients after stroke show a reduced OHRQoL. Medical staff and caregivers should support oral hygiene and dental visits, to foster patients' oral health and OHRQoL.