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Faruque MRJ, Taidouch K, Bikker FJ, Ligtenberg AJM. Exploring the Correlation between Salivary Spinnbarkeit and Caries Scores. Caries Res 2024; 58:115-120. [PMID: 38246142 PMCID: PMC10997273 DOI: 10.1159/000536402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 01/14/2024] [Indexed: 01/23/2024] Open
Abstract
INTRODUCTION In this study, the relationship between the spinnbarkeit, i.e., the stretchability of saliva, and dental caries was investigated. METHODS Dentistry students were divided into a group with more than 2 decayed, missed, and filled teeth (DMFT ≥2, n = 30) and caries-free group (DMFT = 0, n = 36). RESULTS Unstimulated saliva flow rate, pH, and spinnbarkeit were determined. Salivary spinnbarkeit was significantly lower in the caries-prone group compared to the caries-free group (5.4 ± 3.9 mm vs. 13.5 ± 7.6 mm, respectively, p < 0.001). CONCLUSION This suggests that saliva with high spinnbarkeit protects better against dental caries.
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Affiliation(s)
- Mouri R J Faruque
- Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Kawtar Taidouch
- Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Floris J Bikker
- Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Antoon J M Ligtenberg
- Oral Biochemistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
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2
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Analysis of Intervention Effect and Satisfaction of Holistic Nursing after Oral Tumor Resection. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:3788605. [PMID: 35872954 PMCID: PMC9307384 DOI: 10.1155/2022/3788605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 06/22/2022] [Accepted: 07/05/2022] [Indexed: 11/18/2022]
Abstract
Objective. To explore the intervention effect and satisfaction analysis of holistic nursing after oral tumor resection. Methods. A total of 70 oral tumor patients who underwent surgical treatment in our hospital from April 2020 to September 2021 were randomly divided into two groups, with 35 patients in each group. The control group was given basic oral care, the observation group was given overall oral care, and the actual effects of the two groups of care were compared, including the emotional status, compliance and nursing satisfaction, hospital stay and nursing quality scores, pain level, quality of life, and complications occurred. Results. After nursing, the patients in the observation group had good mood, higher compliance and nursing satisfaction, shorter hospital stay, higher nursing quality and quality of life scores, lower pain level, and lower incidence of complications, when compared with the control group. Conclusion. Holistic nursing has obvious effects on patients after oral tumor surgery, which can relieve patients’ negative emotions, improve patients’ compliance with treatment, improve their quality of life, and effectively reduce the degree of pain and the occurrence of complications, which is worthy of clinical promotion.
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Douchy L, Gauthier R, Abouelleil-Sayed H, Colon P, Grosgogeat B, Bosco J. The effect of therapeutic radiation on dental enamel and dentin: A systematic review. Dent Mater 2022; 38:e181-e201. [DOI: 10.1016/j.dental.2022.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 03/03/2022] [Accepted: 04/01/2022] [Indexed: 11/30/2022]
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Harris JA, Ottaviani G, Treister NS, Hanna GJ. An Overview of Clinical Oncology and Impact on Oral Health. FRONTIERS IN ORAL HEALTH 2022; 3:874332. [PMID: 35548170 PMCID: PMC9081678 DOI: 10.3389/froh.2022.874332] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 03/24/2022] [Indexed: 12/24/2022] Open
Abstract
As the incidence of cancer continues to increase, so too will the use of various forms of cancer therapeutics and their associated oral and dental complications. Although many of the acute and chronic oral toxicities of cancer therapy are largely unavoidable, appropriate and timely management of these complications has the potential to alleviate morbidity and improve outcomes. Undoubtedly, the substantial short- and long-term impacts of cancer therapy on the health of the oral cavity requires increased awareness, prevention, and treatment by multidisciplinary healthcare teams consisting of medical oncologists, dentists, and other oral healthcare specialists. This mini review provides a brief purview of the current state of clinical oncology and its impact on oral health. The topics introduced here will be further investigated throughout the remainder of the “Oral Complications in Cancer Patients” mini-review series.
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Affiliation(s)
- Jack A. Harris
- Department of Oral and Maxillofacial Surgery, Harvard School of Dental Medicine, Boston, MA, United States
| | - Giulia Ottaviani
- Pathology, Lino Rossi Research Center, Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Nathaniel S. Treister
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, MA, United States
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, United States
| | - Glenn J. Hanna
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States
- Medicine, Harvard Medical School, Boston, MA, United States
- *Correspondence: Glenn J. Hanna
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5
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Daniels KE, Schaitkin BM. An Update on Nontumorous Disorders of the Salivary Glands and Their Management for Internists. Med Clin North Am 2021; 105:839-847. [PMID: 34391537 DOI: 10.1016/j.mcna.2021.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Salivary disease may present as pain or swelling in unilateral or bilateral salivary glands. Symptoms may be periprandial or recurrent and inflammatory. If a patient fails conservative treatment, they should be referred to an otolaryngologist. If there is no clear cause based on history and physical examination, sialendoscopy can be performed to directly visualize tissues, provide a diagnosis, drive treatment plans, and sometimes concurrently provide therapeutic intervention. Based on the pathology visualized on sialendoscopy, treatment options include endoscopic intervention, Botox, and gland-preserving surgical techniques, which promote healing of glandular tissue, ultimately preserving function.
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Affiliation(s)
- Kelly E Daniels
- University of Pittsburgh Medical Center, 203 Lothrop Street, 5th Floor, Pittsburgh, PA 15213, USA
| | - Barry M Schaitkin
- University of Pittsburgh Medical Center, 203 Lothrop Street, 5th Floor, Pittsburgh, PA 15213, USA.
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6
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Bhandari S, Soni BW, Ghoshal S. Impact of non-compliance with oral care on radiation caries in head and neck cancer survivors. Support Care Cancer 2021; 29:4783-4790. [PMID: 33527227 DOI: 10.1007/s00520-021-06033-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 01/26/2021] [Indexed: 12/01/2022]
Abstract
PURPOSE A cross-sectional study was performed to quantify radiation caries (RC); explore the possible influence of various covariates like elapsed time since radiotherapy, cancer site and stage, treatment modality(ies), grades of xerostomia (GOX), and inter-incisal mouth opening on RC; and also to estimate the unmet treatment needs in head and neck cancer (HNC) survivors, where personal and professional oral care was neglected before and after completion of the treatment. METHODOLOGY Clinical status of the dentition was recorded using decayed missing filled surface/decayed missing filled teeth (DMFS/DMFT) index. Patients were grouped according to the respective covariates, and relevant statistical analysis was performed considering p value ≤ 0.05 as statistically significant. RESULTS Eighty nine patients, 72 males and 17 females, with a mean age of 52.37±11.19 (range 18-70) years were included in this study. Overall, 85% (76/89) and 78% (29/37), 87.5% (35/40), and 100% (12/12) of patients reporting within 1, 1-3, and 3-5 years after RT, respectively, were affected with RC. The mean DMFS/DMFT score, range, and standard deviation in the included patients up to 5 years post-RT were 61.12/15.99, 0-128/0-28, and 36.608/8.66, respectively. Unmet treatment needs concerning dental decay were 97%. A statistically significant difference was found between the mean DMFS with elapsed time since radiotherapy and different GOX, respectively. CONCLUSION Oral health will be worse, treatment needs will be high, and limitations to performing desirable treatment will be numerous in HNC patients, where the oral care component of their treatment is ignored. Future studies are required to identify the true relationship between various risk factors and the development and progression of RC.
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Affiliation(s)
- Sudhir Bhandari
- Unit of Prosthodontics, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
| | - Bhavita Wadhwa Soni
- Unit of Prosthodontics, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sushmita Ghoshal
- Department of Radiotherapy, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Oral Health, Caries Risk Profiles, and Oral Microbiome of Pediatric Patients with Leukemia Submitted to Chemotherapy. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6637503. [PMID: 33532491 PMCID: PMC7834790 DOI: 10.1155/2021/6637503] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/29/2020] [Accepted: 01/06/2021] [Indexed: 02/05/2023]
Abstract
Background Chemotherapy is the primary treatment modality used for patients with acute lymphoblastic leukemia (ALL), but inevitably causes microbiota-related oral complications. This study is aimed at investigating the effects of chemotherapy on oral health status, caries risk, and oral microbiome in pediatric patients with ALL. Methods Thirty-nine children with ALL receiving chemotherapy were enrolled, and a gender-, age-, dentition stage, and socioeconomic class matched healthy counterpart were recruited. Demographic information and overall health condition were obtained through the questionnaire and medical records. Oral examination was performed to assess caries and salivary status, plaque index, and other oral manifestations. Cariogram was used to assess the overall caries risk. Supragingival samples of thirteen ALL subjects and their counterparts were randomly selected to perform a 16S ribosomal RNA gene 454 pyrosequencing. Raw sequence data were screened, trimmed, and filtered using Seqcln and MOTHUR. Results The prevalence of dental caries, gingivitis, oral mucositis, xerostomia, and candidiasis in ALL groups was higher than that of the control group (p < 0.05). Children with ALL demonstrated higher caries risk compared to healthy controls (HC) based upon Cariogram (p < 0.05). The oral microbial structure of ALL patients receiving chemotherapy is different from that of healthy controls. Oral microbiota of ALL groups showed less alpha diversity and significant differences in the composition of the oral microbiome compared to healthy controls. Conclusions ALL patients receiving chemotherapy demonstrated compromised oral health, high caries risk, alteration of caries-related factors, and dysbiosis of oral microbiota. These findings may be of clinical importance in developing better strategies for personalized preventive management of oral diseases for pediatric children with ALL.
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Nasoori A. Tusks, the extra-oral teeth. Arch Oral Biol 2020; 117:104835. [PMID: 32668361 DOI: 10.1016/j.archoralbio.2020.104835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 06/25/2020] [Accepted: 06/25/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The present review aims to: a) describe the features that support tusks in extra-oral position, and b) represent distinctive features of tusks, which provide insights into tusks adaptation to ambient conditions. DESIGN A comprehensive review of scientific literature relevant to tusks and comparable dental tissues was conducted. RESULTS The oral cavity provides a desirable condition which is conducive to tooth health. Therefore, it remains questionable how the bare (exposed) tusks resist the extra-oral conditions. The common features among tusked mammals indicate that the structural (e.g. the peculiar dentinal alignment), cellular (e.g. low or lack of cell populations in the tusk), hormonal (e.g. androgens), and behavioral traits have impact on a tusk's preservation and occurrence. CONCLUSIONS Understanding of bare mineralized structures, such as tusks and antlers, and their compatibility with different environments, can provide important insight into oral biology.
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Affiliation(s)
- Alireza Nasoori
- Graduate School of Veterinary Medicine, Hokkaido University, Kita 18, Nishi 9, Kita-ku, Sapporo, 060-0818, Japan.
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9
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Abstract
Good oral health is an essential part of ageing well. Good mouth care enables people to eat, speak and socialise without pain or embarrassment and contributes hugely to quality of life and general health. Community-dwelling older adults may find access to dental services difficult, and increasing co-morbidities can make self-care a challenge. Older adults are at increased risk of dental disease, and general health complications can make access to dental services and treatment planning difficult. Further, they may find lengthy dental procedures overwhelming. Therefore, there is a need to prevent the decline in oral health in order to maintain general health.
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Affiliation(s)
- Christine Thomas
- Dental Hygienist, University Dental Hospital, Peripheral Hospital Dental Service, Cardiff and the Vale University Health Board
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10
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Pateman KA, Weerakoon AT, Batstone MD, Ford PJ. A culture shock in dental hygiene: Exploring the management of oral health after head and neck cancer. Int J Dent Hyg 2018; 17:183-191. [PMID: 30506841 DOI: 10.1111/idh.12376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 11/02/2018] [Accepted: 11/27/2018] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Managing oral health after the treatment for head and neck cancer requires meticulous daily oral hygiene practices and regular professional dental care; however, the individual factors and health system structures required to achieve oral health are often not well considered. This study aimed to explore how oral health was understood and managed after head and neck cancer treatment and identify factors that influenced oral health behaviours and dental service utilization. METHODS A qualitative, inductive approach was used for data collection and analysis. Sampling of participants was purposive, using a maximum variation approach, and data were analysed using thematic analysis. Participants were recruited from the maxillofacial clinic at a tertiary facility in Brisbane, Queensland, Australia. RESULTS Twenty-one participants took part in the study. Findings described individual and structural factors that influenced the management of oral health post-treatment. Individual determinants of oral health behaviours included a cognitive shift towards lifelong oral health; management of unexpected barriers; and management of competing priorities. Structural factors included availability, accessibility of services, and continuity of care. The ability to fund oral health emerged as a salient theme that influenced both individual and structural factors. CONCLUSIONS Strong self-efficacy and financial and spousal support enhanced the management of oral health, whereas difficulty managing competing issues post-treatment, such as psychological and financial stress, limited participants' capacity to prioritize and manage oral health. Policy initiatives are needed to address the structural barriers caused by a lack of timely access to general and preventive dental care post-treatment.
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Affiliation(s)
- Kelsey A Pateman
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
| | - Arosha T Weerakoon
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
| | - Martin D Batstone
- Royal Brisbane and Women's Hospital, Herston, Brisbane, Queensland, Australia.,School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Pauline J Ford
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
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11
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Irie MS, Mendes EM, Borges JS, Osuna LGG, Rabelo GD, Soares PBF. Periodontal therapy for patients before and after radiotherapy: A review of the literature and topics of interest for clinicians. Med Oral Patol Oral Cir Bucal 2018; 23:e524-e530. [PMID: 30148466 PMCID: PMC6167093 DOI: 10.4317/medoral.22474] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 07/22/2018] [Indexed: 11/22/2022] Open
Abstract
Background To review and discuss important topics regarding periodontal treatment pre- and post-radiotherapy for head and neck cancer in human patients; to discuss the references for adequate techniques, the appropriate moment for tooth extractions and periodontal management; and to discuss the prevention of osteoradionecrosis. Material and Methods Thirty-nine studies including original studies, randomized clinical trials (RCTs) and reviews were searched in online databases MEDLINE (PubMed) and the Cochrane library. No year of publication restriction was applied. Results Language was restricted to English, and the following Medical Subject Heading terms were used: radiotherapy, radiation therapy and periodontal treatment. Studies regarding periodontal treatment and tooth extraction that involved clinical management of irradiated patients were selected. Conclusions The treatment of periodontal diseases before radiotherapy is mainly required to avoid future dental extraction and to reduce the development of osteoradionecrosis. Periodontal treatment in irradiated patients mostly includes scaling and root planing, extraction of condemned teeth and topical and systemic antimicrobial therapy. Tooth removal should be planned at least 14 days before the first day of radiation treatment. Particular care and mouthwashes should be taken during and after radiation. Clinical Significance The management of irradiated patients represents a challenge for health professionals, including dentists. It is important to establish recommendations for clinicians concerning dental and periodontal management in irradiated patients before, during and after treatment. Key words:Head and neck cancer, radiotherapy, periodontal treatment, periodontitis.
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Affiliation(s)
- M-S Irie
- Universidade Federal de Uberlândia, Faculdade de Odontologia, Av. Pará, 1720, Bloco 4L, Anexo A, Campos Umuarama, CEP: 38400-902, Uberlândia, Minas Gerais, Brazil,
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12
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Compositional and functional variations of oral microbiota associated with the mutational changes in oral cancer. Oral Oncol 2018; 77:1-8. [DOI: 10.1016/j.oraloncology.2017.12.005] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 11/26/2017] [Accepted: 12/07/2017] [Indexed: 12/14/2022]
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Sroussi HY, Epstein JB, Bensadoun R, Saunders DP, Lalla RV, Migliorati CA, Heaivilin N, Zumsteg ZS. Common oral complications of head and neck cancer radiation therapy: mucositis, infections, saliva change, fibrosis, sensory dysfunctions, dental caries, periodontal disease, and osteoradionecrosis. Cancer Med 2017; 6:2918-2931. [PMID: 29071801 PMCID: PMC5727249 DOI: 10.1002/cam4.1221] [Citation(s) in RCA: 314] [Impact Index Per Article: 44.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 09/01/2017] [Accepted: 09/01/2017] [Indexed: 12/22/2022] Open
Abstract
Patients undergoing radiation therapy for the head and neck are susceptible to a significant and often abrupt deterioration in their oral health. The oral morbidities of radiation therapy include but are not limited to an increased susceptibility to dental caries and periodontal disease. They also include profound and often permanent functional and sensory changes involving the oral soft tissue. These changes range from oral mucositis experienced during and soon after treatment, mucosal opportunistic infections, neurosensory disorders, and tissue fibrosis. Many of the oral soft tissue changes following radiation therapy are difficult challenges to the patients and their caregivers and require life-long strategies to alleviate their deleterious effect on basic life functions and on the quality of life. We discuss the presentation, prognosis, and management strategies of the dental structure and oral soft tissue morbidities resulting from the administration of therapeutic radiation in head and neck patient. A case for a collaborative and integrated multidisciplinary approach to the management of these patients is made, with specific recommendation to include knowledgeable and experienced oral health care professionals in the treatment team.
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Affiliation(s)
- Herve Y Sroussi
- Division of Oral Medicine & Dentistry, Brigham and Women's Hospital BostonMA
| | - Joel B. Epstein
- Samuel Oschin Comprehensive Cancer InstititueCedars‐Sinai Medical CenterLos AngelesCA
- Division of Otolaryngology and Head and Neck SurgeryDuarteCalifornia
| | | | - Deborah P. Saunders
- Department of Dental OncologyHealth Sciences NorthNortheastern Cancer CentreSudburyOntarioCanada
- Northern Ontario School of MedicineRm 42036SudburyOntarioP3E 5J1Canada
| | - Rajesh V. Lalla
- Section of Oral MedicineUniversity of Connecticut HealthFarmingtonConnecticut
| | - Cesar A. Migliorati
- Department of Oral and Maxillofacial Diagnostic SciencesUniversity of FloridaGainesvilleFlorida
| | - Natalie Heaivilin
- Oral Maxillofacial Surgery DepartmentUniversity of CaliforniaSan FranciscoCalifornia
| | - Zachary S. Zumsteg
- Department of Radiation OncologyCedars‐Sinai Medical CenterLos AngelesCalifornia90048
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14
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Consumption and direct costs of dental care for patients with head and neck cancer: A 16-year cohort study. PLoS One 2017; 12:e0182877. [PMID: 28832673 PMCID: PMC5568378 DOI: 10.1371/journal.pone.0182877] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 07/26/2017] [Indexed: 02/03/2023] Open
Abstract
Patients with head and neck (H&N) cancer are commonly treated with surgery and/or radiotherapy, which can increase the risk of oral infection, dental caries, and periodontal disease. The present study investigated dental care consumption and costs in patient with H&N cancer before and after the cancer diagnosis. Data from Swedish regional and national registers were used to follow up dental care utilization and dental procedure costs. The analysis included 2,754 patients who had been diagnosed with H&N cancer (exposed cohort) in Stockholm County, Sweden, during 2000–2012 and 13,036 matched persons without cancer (unexposed cohort). The exposed cohort was sub-grouped into irradiated and non-irradiated patients for analysis. The exposed cohort underwent a moderately higher number of dental procedures per year than the unexposed cohort in both the year of the cancer diagnosis and the year after cancer diagnosis; in addition, these numbers were higher in the irradiated than in the non-irradiated subgroup of the exposed cohort. Dental care consumption and costs in the exposed cohort declined over time but remained at a slightly higher level than in the unexposed cohort over the long term (more than two years). Examinations and preventive procedures accounted for most of the higher consumption in the short term (2 years) and at the longer term follow-up. Swedish national insurance subsidized costs for dental treatment, which were highest in the irradiated subgroup and lowest in the unexposed cohort. Direct costs to the patient, however, were similar among the groups. Swedish national health insurance protects patients with H&N cancer from high dental expenditures. Further studies on the cost-effectiveness of preventive dental care for patients are needed.
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15
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Lalla RV, Treister N, Sollecito T, Schmidt B, Patton LL, Mohammadi K, Hodges JS, Brennan MT. Oral complications at 6 months after radiation therapy for head and neck cancer. Oral Dis 2017; 23:1134-1143. [PMID: 28675770 DOI: 10.1111/odi.12710] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 05/25/2017] [Accepted: 06/19/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To examine oral complications 6 months after modern radiation therapy (RT) for head and neck cancer (HNC). METHODS Prospective multicenter cohort study of patients with HNC receiving intensity-modulated radiation therapy or more advanced RT. Stimulated whole salivary flow, maximal mouth opening, oral mucositis, oral pain, oral health-related quality of life (OH-QOL), and oral hygiene practices were measured in 372 subjects pre-RT and 216 subjects at 6 months from the start of RT. RESULTS Mean stimulated whole salivary flow declined from 1.09 to 0.47 ml/min at 6 months (p < .0001). Mean maximal mouth opening reduced from 45.58 to 42.53 mm at 6 months (p < .0001). 8.1% of subjects had some oral mucositis at 6 months, including 3.8% with oral ulceration. Mean overall pain score was unchanged. OH-QOL was reduced at 6 months, with changes related to dry mouth, sticky saliva, swallowing solid foods, and sense of taste (p ≤ .0001). At 6 months, there was greater frequency of using dental floss and greater proportion using supplemental fluoride (p < .0001). CONCLUSIONS Despite advances in RT techniques, patients with HNC experience oral complications 6 months after RT, with resulting negative impacts on oral function and quality of life.
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Affiliation(s)
- R V Lalla
- Section of Oral Medicine, MC1605, University of Connecticut Health, Farmington, CT, USA
| | - N Treister
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, MA, USA.,Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
| | - T Sollecito
- Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, Philadelphia, PA, USA.,Division of Oral Medicine, University of Pennsylvania Health System, Philadelphia, PA, USA
| | - B Schmidt
- Department of Oral & Maxillofacial Surgery and Bluestone Center for Clinical Research, New York University College of Dentistry, New York, NY, USA
| | - L L Patton
- Department of Dental Ecology, School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - K Mohammadi
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - J S Hodges
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - M T Brennan
- Department of Oral Medicine, Carolinas Medical Center, Charlotte, NC, USA
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Hassona Y, Scully C. Salivary changes in oral mucosal diseases. Periodontol 2000 2017; 70:111-27. [PMID: 26662486 DOI: 10.1111/prd.12102] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2015] [Indexed: 12/17/2022]
Abstract
Saliva is a unique biological fluid that can be easily collected and analyzed with low cost and low morbidity. Therefore, there is a growing attention for using salivary biomarkers in the diagnosis and monitoring of disease progress and response to treatment. Salivary changes have been described in relation to oral mucosal diseases. This article discusses the causes and consequences of salivary hypofunction and presents a review of the literature related to changes in salivary parameters in various oral mucosal diseases and in systemic diseases with possible oral mucosal involvement.
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17
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Le Bars P, Matamoros S, Montassier E, Le Vacon F, Potel G, Soueidan A, Jordana F, de La Cochetière MF. The oral cavity microbiota: between health, oral disease, and cancers of the aerodigestive tract. Can J Microbiol 2017; 63:475-492. [PMID: 28257583 DOI: 10.1139/cjm-2016-0603] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Many studies show that the human microbiome plays a critical role in the chronic pathologies of obesity, inflammatory bowel diseases, and diabetes. More recently, the interaction between cancer and the microbiome has been highlighted. Most studies have focused on the gut microbiota because it represents the most extensive bacterial community, and the body of evidence correlating it with gut syndromes is increasing. However, in the strict sense, the gastrointestinal (GI) tract begins in the oral cavity, and special attention should be paid to the specific flora of this cavity. This study reviewed the current knowledge about the various microbial ecosystems of the upper part of the GI tract and discussed their potential link to carcinogenesis. The overall composition of the microbial communities, as well as the presence or absence of "key species", in relation to carcinogenesis is addressed. Alterations in the oral microbiota can potentially be used to predict the risk of cancer. Molecular advances and the further monitoring of the microbiota will increase our understanding of the role of the microbiota in carcinogenesis and open new perspectives for future therapeutic and prophylactic modalities.
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Affiliation(s)
- Pierre Le Bars
- a UFR d'odontologie, UIC Odontologie, CHU hôtel-Dieu, Université de Nantes, 1, place Alexis Ricordeau, B.P. 84215, 44042 Nantes CEDEX 1, France
| | - Sébastien Matamoros
- b Walloon Excellence in Life Sciences and Biotechnology, Louvain Drug Research Institute, Metabolism and Nutrition Research Group, Louvain Drug Research Institute, Université catholique de Louvain, 1, place de l'Université, 1348 Brussels, Belgium
| | - Emmanuel Montassier
- c EA 3826 Thérapeutiques cliniques et expérimentales des infections, Faculté de médecine, CHU hôtel-Dieu, Université de Nantes, 1, rue G. Veil, 44000 Nantes, France
| | - Françoise Le Vacon
- d Biofortis Innovation Services - Mérieux NutriSciences, 3, route de la Chatterie, 44800 Saint-Herblain, France
| | - Gilles Potel
- c EA 3826 Thérapeutiques cliniques et expérimentales des infections, Faculté de médecine, CHU hôtel-Dieu, Université de Nantes, 1, rue G. Veil, 44000 Nantes, France
| | - Assem Soueidan
- a UFR d'odontologie, UIC Odontologie, CHU hôtel-Dieu, Université de Nantes, 1, place Alexis Ricordeau, B.P. 84215, 44042 Nantes CEDEX 1, France
| | - Fabienne Jordana
- a UFR d'odontologie, UIC Odontologie, CHU hôtel-Dieu, Université de Nantes, 1, place Alexis Ricordeau, B.P. 84215, 44042 Nantes CEDEX 1, France
| | - Marie-France de La Cochetière
- c EA 3826 Thérapeutiques cliniques et expérimentales des infections, Faculté de médecine, CHU hôtel-Dieu, Université de Nantes, 1, rue G. Veil, 44000 Nantes, France
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Chang C, Liu S, Muo C, Tsai C, Huang Y. Dental Prophylaxis and Osteoradionecrosis: A Population-Based Study. J Dent Res 2017; 96:531-538. [PMID: 28095728 DOI: 10.1177/0022034516687282] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to investigate the association of different dental prophylactic modalities and osteoradionecrosis (ORN) and determine the risk of ORN under different timing periods of scaling, with the use chlorhexidine mouth rinse after surgery and with different strategies of fluoride gel application in head and neck cancer (HNC) participants. A cohort of 18,231 HNC participants, including 941 ORN patients and 17,290 matched control cases, were enrolled from a Longitudinal Health Insurance Database for Catastrophic Illness Patients (LHID-CIP) in Taiwan. Based on different dental prophylactic modalities before radiotherapy, including chlorhexidine mouth rinse, scaling, and fluoride gel, all HNC subjects were stratified into different groups. The Cox proportional hazard regression was used to compare ORN incidences under different dental prophylactic modalities. The results revealed that scaling and chlorhexidine mouth rinse were significantly related to ORN risk ( P = 0.004 and P < 0.0001). Chlorhexidine mouth rinse was highly correlated to ORN occurrence (hazard ratio [HR], 1.83–2.66), as exposure increased the risk by 2.43-fold among oral cancer patients, regardless of whether they had received major oral surgery or not. Oral cancer patients receiving scaling within 2 wk before radiotherapy increased their incidence of ORN by 1.28-fold compared with patients who had not undergone scaling within 6 mo. There is no significance of fluoride application for dental prophylaxis in increasing ORN occurrence. In conclusion, dental prophylaxis before radiotherapy is strongly correlated to ORN in HNC patients. Chlorhexidine exposure and dental scaling within 2 wk before radiotherapy is significantly related to ORN risk, especially in oral cancer patients. The use of 1.1% NaF topical application did not significantly increase the risk of ORN in HNC patients. An optimal dental prophylaxis protocol to reduce ORN should concern cancer location, cautious prescription of chlorhexidine mouth rinse, and proper timing of scaling.
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Affiliation(s)
- C.T. Chang
- Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei, Taiwan
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - S.P. Liu
- Graduate Institute of Basic Medical Science, China Medical University, Taichung, Taiwan
- Center for Neuropsychiatry, China Medical University Hospital, Taichung, Taiwan
- Department of Social Work, Asia University, Taichung, Taiwan
| | - C.H. Muo
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - C.H. Tsai
- Department of Orthopedics, China Medical University Hospital, Taichung, Taiwan
- Graduate Institute of Clinical Medicine, China Medical University, Taichung, Taiwan
| | - Y.F. Huang
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
- Department of General Dentistry, Chang Gung Memorial Hospital, Linkou, Taiwan
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Parahyba CJ, Ynoe Moraes F, Ramos PAM, Haddad CMK, da Silva JLF, Fregnani ER. Radiation dose distribution in the teeth, maxilla, and mandible of patients with oropharyngeal and nasopharyngeal tumors who were treated with intensity-modulated radiotherapy. Head Neck 2016; 38:1621-1627. [DOI: 10.1002/hed.24479] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 01/30/2016] [Accepted: 03/16/2016] [Indexed: 01/23/2023] Open
Affiliation(s)
| | - Fábio Ynoe Moraes
- Department of Radiotherapy; Hospital Sírio-Libanês; São Paulo Brazil
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Le Bars P, Kouadio AA, N'goran JK, Badran Z, Soueidan A. Relationship between removable prosthesis and some systemics disorders. J Indian Prosthodont Soc 2016; 15:292-9. [PMID: 26929530 PMCID: PMC4762353 DOI: 10.4103/0972-4052.171828] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
This article reviews the dental literature concerning the potential impact of the removable prosthesis (RP) on the health status of patients with certain systemic diseases. Literature was surveyed using Medline/PubMed database resources, as well as a manual search, up to 2015 to identify appropriate articles that addressed the aim of this review. The research used keywords about associations between RP and six pathologies: Human immunodeficiency virus infection, diabetes mellitus, pulmonary diseases, gastric-Helicobacter pylori, cancer, and cardiovascular diseases. Analysis of literature showed that in patients with dentures having one or more of the six general conditions listed, Candida albicans organism is more frequently found in the oral flora compared to healthy denture wearer. Although causality has not been established and pending further research on this topic, the hygienic practices necessary to minimize the risk of numerous pathologies should be strengthened in the case of these patients, all the more in the presence of physical or psychological disability. The relationship between the general diseases and increasing of oral candidiasis denture patients is not explained. Therefore, attention to oral hygiene and professional care for removing C. albicans may be beneficial in these medically compromised patients.
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Affiliation(s)
- Pierre Le Bars
- Department of Prosthodonthics, Faculty of Dentistry, CHU Nantes, 1 Place Alexis Ricordeau, 44042 Nantes, France
| | - Alain Ayepa Kouadio
- Department of Prosthodonthics, Faculty of Dentistry, CHU Nantes, 1 Place Alexis Ricordeau, 44042 Nantes, France; Department of Prosthodonthics, Faculty of Dentistry, CHU, Abidjan 22 BP 612, Abidjan, Cote d'Ivoire
| | - Justin Koffi N'goran
- Department of Prosthodonthics, Faculty of Dentistry, CHU, Abidjan 22 BP 612, Abidjan, Cote d'Ivoire
| | - Zahi Badran
- Department of Periodontology, Faculty of Dentistry, CHU Nantes, 1 Place Alexis Ricordeau, 44042 Nantes, France
| | - Assem Soueidan
- Department of Periodontology, Faculty of Dentistry, CHU Nantes, 1 Place Alexis Ricordeau, 44042 Nantes, France
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Santos-Silva AR, Feio PDSQ, Vargas PA, Correa MEP, Lopes MA. cGVHD-Related Caries and Its Shared Features with Other 'Dry-Mouth'-Related Caries. Braz Dent J 2015; 26:435-40. [DOI: 10.1590/0103-6440201300200] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 06/02/2015] [Indexed: 11/22/2022] Open
Abstract
<p>Several systemic diseases and their medical treatment may predispose the development of aggressive dental caries. Head and neck radiotherapy, chemotherapy, Sjögren's syndrome and long-standing treatment with drugs that induce hyposalivation are some of these conditions. The aim of this article is to describe the clinical features of five patients who developed chronic graft-versus-host-disease (cGVHD) as a complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT) and, in spite of close dental follow-up, subsequently developed rampant caries. In these cases, the restorations showed early failure and the caries still progressed until generalized teeth destruction. The majority of the teeth therefore had to be extracted due to advanced dental caries and rapid clinical progression. Herein the term "cGVHD-related caries" is proposed to describe this under-recognized complication of cancer treatment that may evolve in allo-HSCT recipients that develop cGVHD. This condition is poorly recognized in the literature and may represent the final result of the clustering of oral complications in cGVHD patients, including mucositis, oral pain, hyposalivation, taste loss and oral infections, leading to rampant caries due to impaired oral hygiene and increased intake of highly cariogenic food. Consequently, the knowledge of this oral complication should improve the medical and dental management of cGVHD oral manifestations and improve the quality of life of patients with this post allo-HSCT complication.</p>
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de Barros da Cunha SR, Ramos PAM, Nesrallah ACA, Parahyba CJ, Fregnani ER, Aranha ACC. The Effects of Ionizing Radiation on the Oral Cavity. J Contemp Dent Pract 2015; 16:679-687. [PMID: 26423505 DOI: 10.5005/jp-journals-10024-1740] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
AIM The aim of this study is to present a literature review on the effects of the ionizing radiation from radiotherapy treatment on dental tissues. BACKGROUND Among the effects of increasing global life expectancy and longevity of the teeth in the oral cavity, increasing rates of neoplastic diseases have been observed. One of the important treatment modalities for head and neck neoplastic diseases is radiotherapy, which uses ionizing radiation as the main mechanism of action. Therefore, it is essential for dentists to be aware of the changes in oral and dental tissues caused by ionizing radiation, and to develop treatment and prevention strategies. RESULTS In general, there is still controversy about the effects of ionizing radiation on dental structures. However, qualitative and quantitative changes in saliva and oral microbiota, presence of oral mucositis and radiation-related caries are expected, as they represent the well-known side effects of treatment with ionizing radiation. Points that still remain unclear are the effects of radiotherapy on enamel and dentin, and on their mechanisms of bonding to contemporary adhesive materials. CONCLUSION Ionizing radiation has shown important interaction with organic tissues, since more deleterious effects have been shown on the oral mucosa, salivary glands and dentin, than on enamel. CLINICAL SIGNIFICANCE With the increasing number of patients with cancer seeking dental treatment before and after head and neck radiotherapy, it is important for dentists to be aware of the effects of ionizing radiation on the oral cavity.
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Affiliation(s)
- Sandra Ribeiro de Barros da Cunha
- PhD Student, Department of Restorative Dentistry, School of Dentistry University of Sao Paulo, Sao Paulo, Brazil, Phone: +55 11 30917645, e-mail:
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Pateman KA, Ford PJ, Batstone MD, Farah CS. Coping with an altered mouth and perceived supportive care needs following head and neck cancer treatment. Support Care Cancer 2015; 23:2365-73. [DOI: 10.1007/s00520-015-2607-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2014] [Accepted: 01/05/2015] [Indexed: 12/28/2022]
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Halperson E, Moss D, Tickotsky N, Weintraub M, Moskovitz M. Dental pulp therapy for primary teeth in children undergoing cancer therapy. Pediatr Blood Cancer 2014; 61:2297-301. [PMID: 25214367 DOI: 10.1002/pbc.25227] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 07/29/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND Childhood cancer treatment negatively affects the immune system, increasing the risk for bacteremia and septicemia. As the oral cavity is a major entry portal for pathogens into the bloodstream dental care in such children tends to be radical, favouring tooth extraction over less drastic treatments such as pulpotomy, the amputation of infected dental pulp. The present study aimed to compare pulpotomy treatment success rate in children with cancer receiving immunosuppressive therapy with that of healthy children, and investigate if unsuccessful pulpotomy treatment in oncologic patients may lead to systemic complications. PROCEDURE Twenty-six medical records of children from a paediatric oncology referral centre who had dental pulpotomy treatment (in 41 teeth) while receiving active cancer care during the years 2006-2012 were compared with records of 41 randomly selected healthy children who had undergone pulpotomy treatment (41 teeth) in the same institute during these years. Clinical and radiographic data were collected during treatments and at the end of the follow-up period (six months post dental treatment). RESULTS No statisticaly significant difference was found between pulpotomy success rate amongst the two groups. Treatments success rates in the study and control groups were 82.9% (± 5.9) and 90.2% (± 4.7), respectively. No patient in the study group suffered from sepsis from a dental origin during follow-up period. CONCLUSIONS Pulpotomy in paediatric cancer patients did not increase the risk for bacteremia or systemic complications from oral origin. We therefore recommend the re-evaluation of the current protocol for treating paediatric oncology patients.
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Affiliation(s)
- Elinor Halperson
- Department of Pediatric Dentistry, the Hebrew University - Hadassah School of Dental Medicine, Jerusalem, Israel
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Multidisciplinary Treatment Approach in a Patient with History of Nasopharyngeal Carcinoma. Case Rep Dent 2014; 2014:918461. [PMID: 24523971 PMCID: PMC3912759 DOI: 10.1155/2014/918461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Accepted: 12/18/2013] [Indexed: 11/24/2022] Open
Abstract
Radiotherapy in NPC patients has side effects on the dentition, which affects quality of life dramatically. This case report presents multidisciplinary dental treatment approach in a 17-year-old male patient with a history of nasopharyngeal carcinoma (NPC), which was treated with chemotherapy and radiotherapy. The adolescent patient applied to dental hospital 4 years after the radiotherapy with aesthetic and functional problems on dentition affecting psychological, social, and physical aspects of his life. The dentition of the patient demonstrated the severe destruction as a devastating side effect of radiotherapy. With a successful multidisciplinary approach, our patient's aesthetics, function, and self-confidence were obtained. Well-established procedures, which include preventative care and maintenance, can reduce the duration and expenses of the treatment and help in challenging the life-long complications of radiotherapy.
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Bologna-Molina R, Maglia A, Castañeda-Castaneira RE, Molina-Frechero N. Stomatological management of head and neck cancer patients treated with chemotherapy and radiotherapy. World J Stomatol 2013; 2:71-78. [DOI: 10.5321/wjs.v2.i4.71] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Revised: 07/31/2013] [Accepted: 08/06/2013] [Indexed: 02/06/2023] Open
Abstract
Treatment of head and neck cancer with radiotherapy and/or chemotherapy can cause oral damage. Long-term treatment can damage the salivary glands, the oral mucosa, and the maxilla, leading to altered production of saliva and to multiple infections. These lesions can be prevented, limited or avoided by thorough evaluation prior to treatment and by therapeutic follow-up and preventive measures. The dentist must have strong medical knowledge of the possible short-, medium-, and long-term oral complications of the cancer treatment, and must have knowledge of the protocols for oral management of cancer patients. The availability of a multidisciplinary medical team together with a dentist to attend to the patient prior to the cancer treatment, as well as close communication between team members during and after treatment, is crucial. The aim of the present study was review the stomatological management of head and neck cancer patients treated with chemotherapy and radiotherapy and summarizing current treatments, therapeutic innovation and tissue regeneration perspectives.
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Coracin FL, Santos PSDS, Gallottini MHC, Saboya R, Musqueira PT, Barban A, Chamone DDAF, Dulley FL, Nunes FD. Oral health as a predictive factor for oral mucositis. Clinics (Sao Paulo) 2013; 68:792-6. [PMID: 23778491 PMCID: PMC3674268 DOI: 10.6061/clinics/2013(06)11] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Accepted: 02/14/2013] [Indexed: 11/18/2022] Open
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.
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Affiliation(s)
- Fabio Luiz Coracin
- Universidade de São Paulo, School of Dentistry, Department of Oral Pathology, São Paulo/SP, Brazil
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Abstract
The population of the world is aging. A greater proportion of older people are retaining increasing numbers of natural teeth. Aging is associated with changes in oral architecture and muscle weakness, making personal oral hygiene more difficult, particularly for the oldest and most frail individuals. Furthermore, there is exposure of root dentin with its higher pH for demineralization in addition to enamel as a substrate for caries. Aging is also associated, for many in the developed world, with taking multiple medications, with the associated risk of dry mouth. These variables combine to increase caries risk in older vulnerable populations. Caries occurs on both the crowns of teeth (predominantly around existing restorations) and the exposed roots. Prevention needs to be aggressive to control disease in this combination of circumstances, with multiple strategies for limiting the damage associated with caries in this population. This paper explores the evidence that is available supporting preventive strategies, including fluorides in various forms, chlorhexidine, and calcium phosphate supplementation.
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Affiliation(s)
- A W G Walls
- School of Dental Sciences, Framlington Place, Newcastle upon Tyne, NE2 4BW, England, UK.
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Frydrych AM, Slack-Smith LM, Park JH, Smith AC. Expertise regarding dental management of oral cancer patients receiving radiation therapy among Western Australian dentists. Open Dent J 2012; 6:197-207. [PMID: 23284592 PMCID: PMC3529396 DOI: 10.2174/1874210601206010197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2012] [Revised: 09/09/2012] [Accepted: 10/12/2012] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES Dental care forms an important part of the multidisciplinary management of oral cancer patients. The aim of this study was to examine actual and self-perceived knowledge and clinical expertise regarding dental management of oral cancer patients receiving radiation therapy among Western Australian general dentists. MATERIALS AND METHODS An invitation to participate in a web-based questionnaire was emailed to 1095 dentists registered with the Australian Dental Association (ADA), WA branch. To assess dentists' knowledge and expertise, actual and perceived knowledge was investigated. Information regarding type of practice, practice location, year of graduation and number of oral cancer patients treated in the preceding 12 months was also obtained. RESULTS One hundred and ninety one dentists responded to the survey. General dentists who took part in the study appeared to possess some knowledge regarding dental management of oral cancer patients treated with radiation therapy. The majority of responders however identified deficiencies in their knowledge and willingness to participate in continuing education programs. CONCLUSION In view of the rising incidence of oral cancer in Western Australia, efforts should be made to provide more clinically relevant training to dentists in this area.
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Affiliation(s)
- AM Frydrych
- School of Dentistry, The University of Western Australia, Perth, Western Australia
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Lawrence M, Aleid W, McKechnie A. Access to dental services for head and neck cancer patients. Br J Oral Maxillofac Surg 2012; 51:404-7. [PMID: 23127589 DOI: 10.1016/j.bjoms.2012.10.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Accepted: 10/12/2012] [Indexed: 11/27/2022]
Abstract
Dental assessment is important for patients with cancer of the head and neck who are to have radiotherapy, as many of these patients have poor dental health before they start treatment. This, compounded by the fact that radiotherapy to the head and neck has a detrimental effect on oral health, has led the National Institute for Clinical Excellence (NICE) to issue guidance that the dental health of these patients should be assessed before treatment. Unfortunately some multidisciplinary teams, such as the one at United Lincolnshire Hospitals, do not have access to a restorative dentist or a dental hygienist. In a retrospective survey we investigated access to general dental services by patients with head and neck cancer who were to have radiotherapy at our hospital and found that 37/71 (52%) had not been reviewed by a dentist within the past 12 months. A secondary national survey that investigated the availability of restorative dental and dental hygienic services showed that of the 56 multidisciplinary teams that deal with head and neck cancer in England, 19 (34%) do not have access to a restorative dentist and 23 (41%) do not have access to a dental hygienist, suggesting that this problem may be countrywide.
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Affiliation(s)
- Mark Lawrence
- OMFS Department, Clinic 9, Lincoln County Hospital, Greetwell Road, Lincoln LN2 5QY, United Kingdom.
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Schweyen R, Hey J, Fränzel W, Vordermark D, Hildebrandt G, Kuhnt T. [Radiation-related caries: etiology and possible preventive strategies. What should the radiotherapist know?]. Strahlenther Onkol 2011; 188:21-8. [PMID: 22189435 DOI: 10.1007/s00066-011-0011-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2011] [Accepted: 06/30/2011] [Indexed: 11/30/2022]
Abstract
BACKGROUND After radiation treatment of head-and-neck cancer, the impairment of patient's quality of life still remains an issue. After completion of the treatment course, a substantial number of patients develop so-called radiation caries. In addition, almost 50% of all cases of infectious osteoradionecrosis (iORN) of the jaws are directly associated with radiation caries. This review addresses our current knowledge on the etiology and pathogenesis of radiation caries including possible preventive strategies. MATERIALS AND METHODS A PubMed search using the terms "radiation caries" ("radiation related caries", "radiation related damage to dentition") and "radiogenic caries" ("postradiation caries", "dental complications and radiotherapy") was performed. The analysis of its content focused on the etiology, the pathogenesis, and the available knowledge on prophylaxis as well as treatment of radiation caries. RESULTS For this review, 60 publications were selected. As main causal factors for radiogenic caries, either indirect impairment, resulting from alterations in the oral environment (e.g., radiation-induced xerostomia) or direct radiation-induced damage in teeth hard tissues are discussed. Radiation caries remains a lifelong threat and, therefore, requires permanent prevention programs. CONCLUSION To enable optimal medical care of the patients during the time course of radiotherapy as well as afterwards, close interdisciplinary cooperation between radiotherapists, oral surgeons, otorhinolaryngologists, and dentists is absolutely essential.
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Affiliation(s)
- R Schweyen
- Universitätspoliklinik für Prothetik, Martin-Luther-Universität Halle-Wittenberg, Halle-Wittenberg, Deutschland
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Abdelghany A, Nolan A, Freeman R. Treating patients with dry mouth: general dental practitioners' knowledge, attitudes and clinical management. Br Dent J 2011; 211:E21. [PMID: 22116254 DOI: 10.1038/sj.bdj.2011.966] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2011] [Indexed: 11/09/2022]
Abstract
AIM To assess primary care dental practitioners' knowledge, attitudes and clinical management of patients presenting with dry mouth. METHOD A convenience sample of 200 dentists working in primary care in an NHS Health Board in Scotland was obtained. A questionnaire to assess knowledge, attitudes and clinical management of dry mouth patients was sent to all dentists on the NHS primary care service inventory. Ethical approval was obtained. RESULTS Two hundred questionnaires were sent to the participants and 114 were returned, giving a valid response rate of 58%. Fifty percent were woman and 80% worked in the general dental service. Seventy-nine percent had been taught about xerostomia as undergraduates but only 21% had postgraduate educational experiences of dry mouth. The majority correctly stated that patients with Sjögren's syndrome would have an increased risk of dental caries, oral candidosis, frictional oral ulcers and squamous cell carcinoma. Participants had positive attitudes with regard to the importance of treating dry mouth; that it was not a trivial complaint; it affected patients' quality of life and their general health. The dentists were not confident to manage dry mouth patients. Knowledge, attitudes, confidence and intention to treat were affected by gender and type of primary care practice. Thirty-two percent of the variance of the intention to provide treatment was explained by working in the salaried dental service (SDS), confidence and attitudes regarding severity of the condition. CONCLUSIONS Dentists working in the SDS had positive attitudes and increased confidence which were related to postgraduate educational experiences. Education at both undergraduate and postgraduate levels should be supported by clinical exposure to patients in order to improve dentists' confidence and competence to manage xerostomia and its complications.
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Affiliation(s)
- A Abdelghany
- Dental Health Services Research Unit, University of Dundee, Mackenzie Building, Kirsty Semple Way, Dundee, DD2 4BF
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Increased risk for radiation-related caries in cancer patients using topical honey for the prevention of oral mucositis. Int J Oral Maxillofac Surg 2011; 40:1335-6; author reply 1235. [DOI: 10.1016/j.ijom.2011.05.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2011] [Accepted: 05/06/2011] [Indexed: 11/18/2022]
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Meurman JH. Oral microbiota and cancer. J Oral Microbiol 2010; 2. [PMID: 21523227 PMCID: PMC3084564 DOI: 10.3402/jom.v2i0.5195] [Citation(s) in RCA: 110] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2010] [Revised: 06/29/2010] [Accepted: 06/29/2010] [Indexed: 12/15/2022] Open
Abstract
Inflammation caused by infections may be the most important preventable cause of cancer in general. However, in the oral cavity the role of microbiota in carcinogenesis is not known. Microbial populations on mouth mucosa differ between healthy and malignant sites and certain oral bacterial species have been linked with malignancies but the evidence is still weak in this respect. Nevertheless, oral microorganisms inevitably up-regulate cytokines and other inflammatory mediators that affect the complex metabolic pathways and may thus be involved in carcinogenesis. Poor oral health associates statistically with prevalence of many types of cancer, such as pancreatic and gastrointestinal cancer. Furthermore, several oral micro-organisms are capable of converting alcohol to carcinogenic acetaldehyde which also may partly explain the known association between heavy drinking, smoking, poor oral health and the prevalence of oral and upper gastrointestinal cancer. A different problem is the cancer treatment-caused alterations in oral microbiota which may lead to the emergence of potential pathogens and subsequent other systemic health problems to the patients. Hence clinical guidelines and recommendations have been presented to control oral microbiota in patients with malignant disease, but also in this area the scientific evidence is weak. More controlled studies are needed for further conclusion.
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Affiliation(s)
- Jukka H Meurman
- Institute of Dentistry, University of Helsinki, Helsinki, Finland
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