Skip to main content

Advertisement

Log in

Adherence to dental treatment reduces oral complications related to cancer treatment in pediatric and adolescent patients

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

To analyze the association between adherence to dental treatment and (1) oral complications and (2) clinical and sociodemographic aspects of pediatric and adolescent patients with cancer.

Methods

A retrospective cohort study with a sample of 147 children and adolescents who underwent cancer treatment of solid tumors or lymphomas was carried out. The patients were divided into three groups according to previously established criteria. Sociodemographic aspects and oncological, dental, and oral complications were analyzed.

Results

The mean age of patients was 6.7 ± 6.09 years; 57.1% were males and 42.9% were females. Of the 147 patients, 37.41% had full adherence, 33.3% had partial adherence, and 29.3% had non-adherence to the proposed dental treatment. A statistically significant association between oral complications and adherence to dental treatment (p = 0.006) could be observed. The presence of caries lesions at the initial oral examination presented a statistically significant association with adherence to dental treatment (p = 0.004). Children with caries lesions at the initial dental examination had an 88% higher risk of developing oral complications compared with those without caries (RR = 1.88, 95% CI 1.01–3.49). After adjustments for age and the presence of caries lesions at the initial examination, adherence to dental treatment remained the only independent risk factor for oral complications (adjusted RR = 2.56, 95% CI 1.17–5.57).

Conclusions

This study has demonstrated that non-adherence to dental treatment was associated with higher incidence of oral complications and it is a risk factor for these complications. The presence of caries lesions at the initial oral examination was associated with non-adherence to dental treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Epstein JB, Thariat J, Bensadoun RJ, Barasch A, Murphy BA, Kolnick L, Popplewell L, Maghami E (2012) Oral complications of cancer and cancer therapy: from cancer treatment to survivorship. CA Cancer J Clin 62:400–422. https://doi.org/10.3322/caac.21157

    Article  PubMed  Google Scholar 

  2. Nemeth O, Hermann P, Kivovics P, Garami M (2013) Long-term effects of chemotherapy on dental status of children cancer survivors. Pediatr Hematol Oncol 30:208–215. https://doi.org/10.3109/08880018.2013.763391

    Article  PubMed  Google Scholar 

  3. Pixberg C, Koch R, Eich HT, Martinsson U, Kristensen I, Matuschek C, Kortmann RD, Pohl F, Elsayad K, Christiansen H, Willich N, Lindh J, Steinmann D (2016) Acute toxicity grade 3 and 4 after irradiation in children and adolescents: results from the IPPARCA collaboration. Int J Radiat Oncol Biol Phys 94:792–799. https://doi.org/10.1016/j.ijrobp.2015.12.353

    Article  PubMed  Google Scholar 

  4. Berger Velten D, Zandonade E, Monteiro de Barros Miotto MH (2016) Prevalence of oral manifestations in children and adolescents with cancer submitted to chemotherapy. BMC Oral Health 16:107. https://doi.org/10.1186/s12903-016-0300-2

    Article  PubMed  PubMed Central  Google Scholar 

  5. Gandhi K, Datta G, Ahuja S, Saxena T, Datta AG (2017) Prevalence of oral complications occurring in a population of pediatric cancer patients receiving chemotherapy. Int J Clin Pediatr Dent 10:166–171. https://doi.org/10.5005/jp-journals-10005-1428

    Article  PubMed  PubMed Central  Google Scholar 

  6. Vasconcelos RM, Sanfilippo N, Paster BJ, Kerr AR, Li Y, Ramalho L, Queiroz EL, Smith B, Sonis ST, Corby PM (2016) Host-microbiome cross-talk in oral mucositis. J Dent Res 95:725–733. https://doi.org/10.1177/0022034516641890

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Qutob AF, Gue S, Revesz T, Logan RM, Keefe D (2013) Prevention of oral mucositis in children receiving cancer therapy: a systematic review and evidence-based analysis. Oral Oncol 49:102–107. https://doi.org/10.1016/j.oraloncology.2012.08.008

    Article  PubMed  Google Scholar 

  8. Bousaadani AE, Eljahd L, Abada R, Rouadi S, Roubal M, Mahtar M (2016) Prevention and treatment of mucositis in children with oral cancers: practical recommendations. Cancer/Radiothérapie 20:226–230. https://doi.org/10.1016/j.canrad.2015.11.006

    Article  Google Scholar 

  9. Villa A, Sonis ST (2015) Mucositis: pathobiology and management. Curr Opin Oncol 27:159–164. https://doi.org/10.1097/CCO.000000000000018

    Article  CAS  PubMed  Google Scholar 

  10. Cheng KK, Lee V, Li CH, Yuen HL, Epstein JB (2012) Oral mucositis in pediatric and adolescent patients undergoing chemotherapy: the impact of symptoms on quality of life. Support Care Cancer 20:2335–2342. https://doi.org/10.1007/s00520-011-1343-1

    Article  PubMed  Google Scholar 

  11. Mendonça RMH, Araújo M, Levy CE, Morari J, Silva RA, Yunes JA, Brandalise SR (2011) Prospective evaluation of HSV, Candida spp. and oral bacteria on the severity of oral mucositis in pediatric acute lymphoblastic leukemia. Support Care Cancer 20:1101–1107. https://doi.org/10.1007/s00520-011-1190-0

    Article  PubMed  Google Scholar 

  12. Wang Y, Zhou X, Xu X (2015) Oral microbiota: an overlooked etiology for chemotherapy-induced oral mucositis? J Formos Med Assoc 114:297–299. https://doi.org/10.1016/j.jfma.2013.10.014

    Article  PubMed  Google Scholar 

  13. Cheng KKF, Goggins WB, Lee VWS, Thompson DR (2008) Risk factors for oral mucositis in children undergoing chemotherapy: a matched case-control study. Oral Oncol 44:1019–1025. https://doi.org/10.1016/j.oraloncology.2008.01.003

    Article  PubMed  Google Scholar 

  14. Glenny AM, Gibson F, Auld E, Coulson S, Clarkson JE, Craig JV, Eden OB, Khalid T, Worthington HV, Pizer B (2010) The development of evidence-based guidelines on mouth care for children, teenagers and young adults treated for cancer. Eur J Cancer 46:1399–1412. https://doi.org/10.1016/j.ejca.2010.01.023

    Article  CAS  PubMed  Google Scholar 

  15. Hong CHL, Napeñas JJ, Hodgson BD, Stokman MA, Mathers-Stauffer V, Elting LS, Spijkervet FKL, Brennan MT (2010) A systematic review of dental disease in patients undergoing cancer therapy. Support Care Cancer 18:1007–1021. https://doi.org/10.1007/s00520-010-0873-2

    Article  PubMed  PubMed Central  Google Scholar 

  16. Mendonça RMH, Araújo M, Levy CE, Morari J, Silva RA, Yunes JA, Brandalise SR (2015) Oral mucositis in pediatric acute lymphoblastic leukemia patients: evaluation of microbiological and hematological factors. Pediatr Hematol Oncol 32:322–330. https://doi.org/10.3109/08880018.2015.1034819

    Article  CAS  PubMed  Google Scholar 

  17. Cheng KKF, Mollassiotis A, Chang AM, Wai WC, Cheung SS (2001) Evaluation of an oral care protocol intervention in the prevention of chemotherapy- induced oral mucositis in paediatric cancer patients. Eur J Cancer 37:2056–2063

    Article  CAS  Google Scholar 

  18. Coracin FL, Santos PSS, Gallottini MH, Saboya R, Musqueira PT, Barban A, Chamone D de A, Dulley FL, Nunes FD (2013) Oral health as a predictive factor for oral mucositis. Clinics (Sao Paulo) 68:792–796. https://doi.org/10.6061/clinics/2013(06)11

    Article  Google Scholar 

  19. Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, for the STROBE Initiative (2014) The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Int J Surg 12:1495–1499. https://doi.org/10.1016/j.ijsu.2014.07.013

    Article  Google Scholar 

  20. WHO. World Heath Organization (2016) Adolescent health. Accessed on 12 Nov 2017. Available in: http://www.who.int/topics/adolescent_health/en/

  21. Brasil. Ministério da Saúde. Programa de Saúde do Adolescente. Bases programáticas. 2a Edição. Brasília; Ministério da Saúde, 1996

  22. Steliarova-Foucher E, Stiller C, Lacour B, Kaatsch P (2005) International classification of childhood cancer, 3rd edn. Cancer 103:1457–1467

    Article  Google Scholar 

  23. National Cancer Institute. Cancer therapy evaluation program (2006) Common terminology criteria for adverse events v.3. Available in: http://ctep.cancer.gov/protocolDevelopment/electronic_applications/docs/ctcaev3.pdf Date of Publication: August 9, 2006. Accessed on 19 Oct 2015

  24. Brasil. Ministério da Educação. Etapas do sistema educacional brasileiro. Available in: http://www.brasil.gov.br/editoria/educacao-e-ciencia/2014/05/saiba-como-e-a-divisao-do-sistema-de-educacao-brasileiro/view. Accessed on 12 Nov 2017

  25. WHO. World Health Organization (2003) Adherence to long-term therapies: evidence for action. Genebra: WHO. Accessed on 12 Nov 2017. Available in: http://www.who.int/chp/knowledge/publications/adherence_full_report.pdf?ua=1

  26. Morais MO, Elias MRA, Leles CR, Pinezi JCD, Mendonça EF (2016) The effect of preventive oral care on treatment outcomes of a cohort of oral cancer patients. Support Care Cancer 24:1663–1670. https://doi.org/10.1007/s00520-015-2956-6

    Article  PubMed  Google Scholar 

  27. Albuquerque RA, Morais VLL, Sobral APV (2007) Avaliação clínica da frequência de complicações orais e sua relação com a qualidade de higiene bucal em pacientes pediátricos submetidos a tratamento antineoplásico. Arq Odontol 43:9–16

    Google Scholar 

  28. Otmani N, Alami R, Hessissen L, Mokhtari A, Soulaymani A, Khattab M (2011) Determinants of severe oral mucositis in paediatric cancer patients: a prospective study. Int J Pediatr Dent 21:210–216. https://doi.org/10.1111/j.1365-263X.2011.01113.x

    Article  Google Scholar 

  29. Vento S, Cainelli F (2003) Infections in patients with cancer undergoing chemotherapy: aetiology, prevention, and treatment. Lancet Oncol 4:595–604

    Article  Google Scholar 

  30. Santos de Faria AB, Silva IH, de Godoy Almeida R, Silva SP, Carvalho AT, Leão JC (2014) Seroprevalence of herpes virus associated with the presence and severity of oral mucositis in children diagnosed with acute lymphoid leukemia. J Oral Pathol Med 43:298–303. https://doi.org/10.1111/jop.12138

    Article  PubMed  Google Scholar 

  31. Elad S, Raber-Durlacher JE, Brennan MT, Saunders DP, Mank AP, Zadik Y, Quinn B, Epstein JB, Blijlevens NMA, Waltimo T, Passweg JR, Correa MEP, Dahllöf G, Garming-Legert KUE, Logan RM, Potting CMJ, Shapira MY, Soga Y, Stringer J, Stokman MA, Vokurka S, Wallhult E, Yarom N, Jensen SB (2014) Basic oral care for hematology–oncology patients and hematopoietic stem cell transplantation recipients: a position paper from the joint task force of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) and the European Society for Blood and Marrow Transplantation (EBMT). Support Care Cancer 23:223–236. https://doi.org/10.1007/s00520-014-2378-x

    Article  PubMed  PubMed Central  Google Scholar 

  32. Kashiwazaki H, Matsushita T, Sugita J, Shigematsu A, Kasashi K, Yamazaki Y, Kanehira T, Yamamoto S, Kondo T, Endo T, Tanaka J, Hashino S, Nishio M, Imamura M, Kitagawa Y, Inoue N (2012) Professional oral health care reduces oral mucositis and febrile neutropenia in patients treated with allogeneic bone marrow transplantation. Support Care Cancer 20:367–373. https://doi.org/10.1007/s00520-011-1116-x

    Article  PubMed  Google Scholar 

  33. Yamagata K, Arai C, Sasaki H, Takeuchi Y, Onizawa K, Yanagawa T, Ishibashil N, Karubel R, Shinozuka K, Hasegawa Y, Chiba S, Bukawa H (2012) The effect of oral management on the severity of oral mucositis during hematopoietic stem cell transplantation (HSCT). Bone Marrow Transplant 47:725–730. https://doi.org/10.1038/bmt.2011.171

    Article  CAS  PubMed  Google Scholar 

  34. Yavuz B, Yılmaz HB (2015) Investigation of the effects of planned mouth care education on the degree of oral mucositis in pediatric oncology patients. J Pediatr Oncol Nurs 32:47–56. https://doi.org/10.1177/1043454214554011

    Article  PubMed  Google Scholar 

  35. McGuire DB, Fulton JS, Park J, Brown CG, Correa MEP, Eilers J, Elad S, Gibson F, Oberle-Edwards LK, Bowen J, Lalla RV (2013) Systematic review of basic oral care for the management of oral mucositis in cancer patients. Support Care Cancer 21:3165–3177. https://doi.org/10.1007/s00520-013-1942-0

    Article  PubMed  Google Scholar 

  36. Listl S, Moeller J, Manski R (2014) A multi-country comparison of reasons for dental non-attendance. Eur J Oral Sci 122:62–69. https://doi.org/10.1111/eos.12096

    Article  PubMed  Google Scholar 

  37. Badri P, Saltaji H, Flores-Mir C, Amin M (2014) Factors affecting children’s adherence to regular dental attendance A systematic review. JADA 145:817–828. https://doi.org/10.14219/jada.2014.49

    Article  PubMed  Google Scholar 

  38. Ardenghi TM, Vargas-Ferreira F, Piovesan C, Mendes FM (2012) Age of first dental visit and predictors for oral health care utilisation in preschool children. Oral Health Prev Dent 10:17–27

    PubMed  Google Scholar 

  39. Goettems ML, Ardenghi TM, Demarco FF, Romano AR, Torriani DD (2012) Children’s use of dental services: influence of maternal dental anxiety, attendance pattern, and perception of children’s quality of life. Community Dent Oral Epidemiol 40:451–458

    Article  Google Scholar 

  40. Machry RV, Tuchtenhagen S, Agostini BA, da Silva Teixeira CR, Piovesan C, Mendes FM, Ardengui TM (2013) Socioeconomic and psychosocial predictors of dental healthcare use among Brazilian preschool children. BMC Oral Health 13:60. https://doi.org/10.1186/1472-6831-13-60

    Article  PubMed  PubMed Central  Google Scholar 

  41. Freddo SL (2017) Aspectos relacionados à adesão ao tratamento odontológico na adolescência: abordagem quanti qualitativa. Tese, Universidade Estadual de Campinas, Brasil

  42. Gupta A, Mawaha M, Bansal K, Sachdeva A, Gupta A (2016) Dental awareness among parents and oral health of paediatric cancer patients receiving chemotherapy. J Clin Diagn Res 10:ZC92–ZC95. https://doi.org/10.7860/JCDR/2016/17412.7819

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgments

The authors thank all team members of the Centro Infantil Boldrini for their cooperation.

Funding

The authors thank the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), a Brazilian governmental agency responsible for quality assurance in postgraduate courses, for its financial support (Grant Number 1732/2016).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Rafaela Maia Almendra Mattos.

Ethics declarations

Research was conducted with the approval of the Brazilian National Ethical Committee (CAAE 51995415.5.5.0000.5376).

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Institution at which the work was performed: Centro Infantil Boldrini

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Almendra Mattos, R.M., de Mendonça, R.M.H. & dos Santos Aguiar, S. Adherence to dental treatment reduces oral complications related to cancer treatment in pediatric and adolescent patients. Support Care Cancer 28, 661–670 (2020). https://doi.org/10.1007/s00520-019-04857-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-019-04857-3

Keywords

Navigation