Orofacial complaints and complications of chemotherapy
Abstract
Background: Oral complications of chemotherapy are sometimes unnoticed and if not treated, they can compromise patients’ health and quality of life. Methods: This study aimed to assess and characterize orofacial complaints and complications, and their impact on the oral-health-related quality of life in patients undergoing cancer chemotherapy. Results: We evaluated 28 patients with solid tumors undergoing chemotherapy, through a systematic orofacial evaluation. Eighteen patients (64.2%) developed oral complications during chemotherapy and xerostomia scored the highest incidence n = 14 (50%). About oral health data, gingival index revealed greater part of patients classified with moderate or severe gingival inflammation. The mean plaque index was 25.6%. The mean CPOD index was 15.48 and was worse in patients without oral complications. The patients presented higher index of plaque and the oral health impact profile showed higher mean index in the patients group that developed oral complications. Conclusion: These data reinforce the crucial role of the dentist being in the multidisciplinary team, helping in the diagnosis of oral complications and provide a specific relieve of patient’s complaints, impacting positively on their quality of life.
References
Epstein JB, Thariat J, Bensadoun RJ, et al. Oral Complications of Cancer and Cancer Therapy: From Cancer Treatment to Survivorship. Cancer J Clin. 2012;62:400-22.
Brennan MT, Elting LS, Spijkervet FKL. Systematic reviews of oral complications from cancer therapies, Oral Care Study Group, MASCC/ISOO: Methodology and quality of the literature. Support Care Cancer. 2010;18(8):979-84. PubMed PMID: 20306090
Cooperstein E, Gilbert J, Epstein JB, et al. Vanderbilt Head and Neck Symptom Survey version 2.0: Report of the development and initial testing of a subscale for assessment of oral health. Head Neck. 2012;34(6):797-804. PubMed PMID: 22127786
Moslemi D, Nokhandani AM, Otaghsaraei MT, et al. Management of chemo/radiation-induced oral mucositis in patients with head and neck cancer: A review of the current literature. Radiother Oncol. 2016;120(1):13-20. PubMed PMID: 27113797
Kapoor V, Basur S, Pandey A. Chemotherapy and Oral Complications: The Most Neglected Side of Cancer. J Adv Med Dent Scie Res. 2015;3:71-80.
Barkokebas A, Silva IHM, Andrade SC, et al. Impact of oral mucositis on oral-health-related quality of life of patients diagnosed with cancer. J Oral Pathol Med. 2015;44(9):746-51. PubMed PMID: 25345344
Dholam KP, Dugad JA, Sadashiva KM. Impact of oral rehabilitation on patients with head and neck cancer: A study using the Liverpool Oral Rehabilitation Questionnaire and the Oral Health Impact Profile-14. J Prosthet Dent. 2017;117(4):559-62. PubMed PMID: 27765395
Magnabosco Neto AE, Westphalen FH. Analysis of oral complications related to cancer therapy. Arch Oral Res. 2013;9:159-64.
Tunkel AR, Sepkowitz KA. Infections Caused by Viridans Streptococci in Patients with Neutropenia. Clin Infect Dis. 2002;34(11):1524-9. PubMed PMID: 12015700. doi: 10.1086/340402
El Bousaadani A, Eljahd L, Abada R, et al. Prevention and treatment of mucositis in children with oral cancers: Practical recommendations. Cancer Radiother. 2016;20(3):226-30. PubMed PMID: 27032624
Scully C, Sonis S, Diz PD. Oral mucositis. Oral Dis. 2006;12(3):229-41. PubMed PMID: 16700732. doi: 10.1111/j.1601-0825.2006.01258.x
Scully C, Epstein J, Sonis S. Oral mucositis: A challenging complication of radiotherapy, chemotherapy, and radiochemotherapy: Part 1, pathogenesis and prophylaxis of mucositis. Head Neck. 2003;25(12):1057-70. PubMed PMID: 14648865. doi: 10.1002/hed.10318
Al-ansari S, Zecha JA, Barasch A, et al. Oral Mucositis Induced By Anticancer Therapies. Curr Oral Health Rep. 2015;2:202-11.
Hayashi H, Kobayashi R, Suzuki A, et al. Preparation and clinical evaluation of a novel lozenge containing polaprezinc, a zinc-L-carnosine, for prevention of oral mucositis in patients with hematological cancer who received high-dose chemotherapy. Med Oncol. 2016;33(8):91.
Fulton JS, Middleton GJ, McPhail JT. Management of oral complications. Semin Oncol Nurs. 2002;18(1):28-35. PubMed PMID: 11878036
Naidu MU, Ramana GV, Rani PU, et al. Chemotherapy-induced and/or radiation therapy-induced oral mucositis-complicating the treatment of cancer. Neoplasia. 2004;6:423-31.
Pinna R, Campus G, Cumbo E, et al. Xerostomia induced by radiotherapy: An overview of the physiopathology, clinical evidence, and management of the oral damage. Ther Clin Risk Manag. 2015;4:171-88.
Eveson JW. Xerostomia. Periodontology 2000. 2008;48(1):85-91. doi: 10.1111/j.1600-0757.2008.00263.x
Turner L, Mupparapu M, Akintoye SO. Review of the complications associated with treatment of oropharyngeal cancer: A guide for the dental practitioner. Quintessence Int. 2013;44(3):267-79. PubMed PMID: 23444208
Mortazavi S, Imanimoghaddam M, Davachi B, et al. Evaluation of magnetic resonance sialography and ultrasonography findings in salivary glands of patients with xerostomia. Cumhuriyet Dent. J 2016;19:23-34.
Miranda-Rius J, Brunet-Llobet L, Lahor-Soler E, et al. Salivary secretory disorders, inducing drugs, and clinical management. Int J Med Sci. 2015;12(10):811-24. PubMed PMID: 26516310
Noll SF, Bender CE, Nelson MC. Rehabilitation of patients with swallowing disorders, 1st ed. Philadelphia: W. B. Saunders; 1996.
Dysphagia Section, Oral Care Study Group, Multinational Association of Supportive Care in Cancer (MASCC)/International Society of Oral Oncology (ISOO), Raber-Durlacher JE, Brennan MT, Verdonck-de Leeuw IM, et al. Swallowing dysfunction in cancer patients. Support Care Cancer. 2012;20:433-43.
Lemos EM, Santoro PP, Tavares RA, et al. Oropharyngeal dysphagia in dermatomyosites: Case report and literature review. Braz J Otorhinolaryngol. 2008;74:938-40.
Coronado-Castellote L, Jimenez-Soriano Y. Clinical and microbiological diagnosis of oral candidiasis. J Clin Exp Dent. 2013;5:279-86.
Melkoumov A, Goupil M, Louhichi F, et al. Nystatin nanosizing enhances in vitro and in vivo antifungal activity against Candida albicans. J Antimicrob Chemother. 2013;68(9):2099-105. PubMed PMID: 23620465
Epstein JB, Polsky B. Oropharyngeal candidiasis: A review of its clinical spectrum and current therapies. ClinTher. 1998;20:40-57.
Epstein JB, Elad S, Eliav E, et al. Orofacial pain in cancer: Part II: Clinical perspectives and management. J Dent Res. 2007;86(6):506-18. PubMed PMID: 17525349
Siqueira JTT, Jales S, Vilarim RCB. Dor orofacial e cuidados paliativos orais em pacientes com câncer. Revista Onco. 2013;25-8.
Wang T, Chang Y, Wu M, et al. Evaluating Swallowing Dysfunction Using a 100-ml Water Swallowing Test. Dysphagia. 2004;19(1):43-7. PubMed PMID: 14745645. doi: 10.1007/s00455-003-0030-x
Fox PC, Busch KA, Baum BJ. Subjective reports of xerostomia and objective measure of salivary gland performance. J Dent Assoc. 1987;115:581-4.
Pai S, Ghezz EM, Ship JA. Development of a visual analogue scale questionnaire for subjective assessment of salivary dysfunction. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001;3:311-6.
Slade GD, Spencer AJ. Development and evaluation of the Oral Health Impact Profile. Community Dent Health. 1994;11(1):3-11. PubMed PMID: 8193981
Almeida PM, Wickerhauser H. Critério ABA (AssociaçãoBrasileira de Anunciantes) e ABIPEME (AssociaçãoBrasileira dos Institutos de Pesquisa de mercado). 1991.
Wong HM. Oral complications and management strategies for patients undergoing cancer therapy. Scientific World Journal. 2014;7:1-14.
World Health Organization. Handbook for reporting results of cancer treatment. Geneve; 1979.
Gomes SGF, Cury AADB, Garcia RCMR. Effect of hyposalivation on mastication and mandibular movements during speech. Braz Oral Res. 2011;4:25.
Cheng KK, Leung SF, Liang RHS, et al. Severe oral mucositis associated with cancer therapy: Impact on oral functional status and quality of life. Support Care Cancer. 2010;18(11):1477-85. PubMed PMID: 19916030
Savioli C, Ribeiro ACM, Fabri GMC, et al. Persistent periodontal disease hampers anti-tumor necrosis factor treatment response in rheumatoid arthritis. J Clin Rheumatol. 2012;18(4):180-4. PubMed PMID: 22647860
Chapple ILC, Genco R, Working group 2 of the joint EFP/AAP workshop. Diabetes and periodontal diseases: Consensus report of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases. J Periodontol. 2013;84:106-12.
Ewan VC, Sails AD, Walls AW, et al. Dental and microbiological risk factors for hospital-acquired pneumonia in non-ventilated older patients. PLoS One. 2015;10(4).
Allareddy V, Elangovan S, Rampa S, et al. Presence of gingivitis and periodontitis significantly increases hospital charges in patients undergoing heart valve surgery. J Mass Dent Soc. 2015;63(4):10-6. PubMed PMID: 25872281
Berglund E, Westerling R, Lytsy P. Social and health-related factors associated with refraining from seeking dental care: A cross-sectional population study. Community Dent Oral Epidemiol. 2017;45(3):258-65.
Tan EC, Lexomboon D, Sandborgh-Englund G, et al. Medications that cause dry mouth as an adverse effect in older people: A systematic review and metaanalysis. J Am Geriatr Soc. 2017 Oct 26. doi: 10.1111/jgs.15151.