Oncology Patients

Source of information: “Dentistry guide for parents and carers of children with disabilities and health problems” of the Pediatric Dental Association of Cyprus

In the majority of cases the diagnosis of the disease is done at a very young age (<5 years) and the child may have not gone yet for his first Dental check. Both Leukaemia as a disease and treatments for the patient causes a decline in the body’s’ defence, resulting in several serious and sometimes painful Dental problems.

Tooth decalcifications (severe calcium loss) after vomiting during the chemotherapy treatment.

Gingivitis

• There must be a coordinated and team effort to better treat, alleviate from pain and support the Pediatric patient throughout their treatment, with the goal of a better quality of life.
• Dry mouth causes a significant decrease in saliva and the growth of microbes in the mouth, thus increasing the risk of caries.

Cooping mechanism at the Dental clinic

Prior to initiating treatment against Leukaemia, a dental assessment should be performed because there may be carious lesions on the teeth or other pathological problems. These problems need to be treated prior to initiating the Leukaemia treatment, in order to avoid complicated and painful conditions.

The patient must follow a strict Dental preventive program throughout his treatment. Frequent Fluoride treatments and cleanings per quadrant will greatly help to strengthen the teeth and reduce decay, while the Dentist will provide the necessary home care products according to the patient’s needs.

Home care

• Depending on the stage of treatment, the symptoms and type of dental care will also vary (immunosuppression etc.). Try to brush daily, in the morning and night time with a soft toothbrush and using a Fluoride based toothpaste.
• Use an Antiseptic mouthwash 3-4 times a day to reduce the Dental plaque (and possibly relieve from Aphthous lesions and limit Fungal infections). In times where brushing is very painful and difficult it is very important to persist even with the use of special sponges (swabs).
• Use of a Fluoride based toothpaste (5000 ppm Fluoride), use of a Calcium-Phosphorus paste for remineralisation of the teeth, and use of an antibacterial mouthwash according to the patient’s needs.
• Use of Antifungals only and when needed.
• Relief of Xerostomia and symptoms of Fungal infection with (leave it to melt in the mouth) crushed ice (unless contraindicated for certain chemotherapeutic drugs). There are other Xerostomia remedies that can be advised by the child’s Oncologist.
• Avoid burning and sour foods, very hot food and drinks, burning toothpaste (strong mint) and sweets.
• At older ages, if the child performs Orthodontic treatment, he or she should discontinue it for at least 1 year after completing treatment.

Mycosis during chemotherapy