A comparative evaluation of dental caries status and salivary properties of children aged 5-14 years undergoing treatment for acute lymphoblastic leukemia, type I diabetes mellitus, and asthma - In vivo

Antineoplastic therapy is an independent risk factor for dental caries in childhood cancer patients: a retrospective cohort study

PURPOSE

To evaluate the antineoplastic therapy (AT) as a risk factor for dental caries lesions independent of other risk factors such as income, family education, stimulated salivary flow rate, hygiene habits, frequency of sugar intake, and microbiota in childhood cancer (CC) patients.

METHODS

72 individuals were divided into CC patients (n=36) and healthy individuals (control group - CT n=36). Demographic data, hygiene habits, frequency of sugar intake, CC type, and AT were collected. Stimulated salivary flow rate was measured and the presence and concentration of Streptococcus mutans were assessed using a real-time polymerase chain reaction (qPCR) technique. Clinical evaluations included plaque index (PI) and decayed-missing-filled-teeth index (dmft/DMFT). Descriptive statistics, T-test, Mann-Whitney test, chi-square test, Fisher's exact test, and two-way analysis of variance were used for data analysis (p<0.05).

RESULTS

At the time of oral evaluation, both groups exhibited similar ages with means of 12.0±3.9 years old for CC and 12.0±4.0 years old for CT patients. All CC patients underwent chemotherapy with nine also undergoing radiotherapy. Significant differences were observed between the groups in terms of color/race, income, family education, and hygiene habits. However, no statistically significant differences were found between groups regarding the frequency of sugar intake, stimulated salivary flow rate, or the concentration of Streptococcus mutans (qPCR technique). For clinical parameters, the DMF (CC:1.80, CT: 0.75), decayed (CC: 0.88, CT: 0.19), missing (CC: 0.25, CT:0), and PI (CC: 30.5%, CT: 22.6%) were higher in the CC group (p<0.05).

CONCLUSION

Childhood cancer (CC) patients undergoing antineoplastic therapy (AT) exhibit a higher prevalence of dental caries, regardless of income/education, frequency of sugar intake, stimulated salivary flow rate, and microbiota.

Assessment of the Changes in the Salivary Profile and Its Clinical Correlation in Children with Acute Lymphoblastic Leukemia Undergoing Chemotherapy: A Follow-up Study

Aim

To assess the changes in salivary profile and its clinical correlation in patients with acute lymphoblastic leukemia (ALL) undergoing chemotherapy.

Materials and methods

Children who have been diagnosed with ALL undergoing chemotherapy at Bharati Hospital, Pune, were included in the study. Those children were included who fulfilled the following inclusion and exclusion criteria. Stimulated salivary samples were collected in sterile vials at 1-, 3-, and 6-month intervals and ware assessed for salivary pH and buffering capacity. Caries and oral manifestations were also checked at each interval.

Results

A total of 25 children with ALL undergoing chemotherapy were included to participate in the study. The results were analyzed using Statistical Package for the Social Sciences software. There was a statistically significant difference in the change in salivary pH during the 1st and 6th months of chemotherapy (p-value of 0.001). Salivary buffering capacity was also found to be low in these patients during the 1st month of chemotherapy, which gradually increased during the entire course of chemotherapy (p-value of 0.011). Progression of dental caries was seen during the entire course of treatment.

Conclusion

All the major changes were seen in the 1st month, that is, the induction phase of chemotherapy. Hence, we can say this is the most affected phase of chemotherapy.

Clinical significance

The parents and children should be educated and motivated to maintain proper oral hygiene. Whenever possible, all preventive dental procedures should be undertaken before the start of chemotherapy to avoid future complications.

How to cite this article

Paranjape MN, Shah P, Patil S, et al. Assessment of the Changes in the Salivary Profile and Its Clinical Correlation in Children with Acute Lymphoblastic Leukemia Undergoing Chemotherapy: A Follow-up Study. Int J Clin Pediatr Dent 2023;16(S-3):S268-S271.

Assessment of Oral Health-related Quality of Life in Patients Suffering from Systemic Diseases

Aim

To assess the oral health-related quality of life (OHRQoL) among children suffering from congestive heart failure and bronchial asthma in Lucknow city.

Materials and method

Methodology: Patients aged 6–12 years were assessed using Child Perception Questionnaire (CPQ). DMFT was assessed in same patients to measure their caries experience.

Results

Dental caries were observed in 62.6% of cardiac patients followed by 55.8% in bronchial asthma patients.

Conclusion

Children with CHF had high dental caries experience as compared to asthmatic patients. Due to high caries exposure, they had a negative impact on OHRQoL as compared to others.

Clinical significance

The relationship between oral and systemic health must be consistently reinforced to a patient and guardians of children with systemic disease that can enable to improve the quality of life of these compromised populations.

How to cite this article

Dhinsa K, Saha S, Tripathi AM, et al. Assessment of Oral Health-related Quality of Life in Patients Suffering from Systemic Diseases. Int J Clin Pediatr Dent 2021;14(6):779–783.

Oral health status of patients with leukemia: a systematic review with meta-analysis

OBJECTIVE

The aim of this study was to systematically review the literature regarding the prevalence of periodontal diseases and dental caries in patients with leukemia.

METHODS

An electronic search for observational studies on oral health outcomes in patients with leukemia was performed on Medline/PUBMED, Embase, Web of Science, and Science Direct databases up to April 2020. Dental caries and periodontal diseases were assessed using the following standardized parameters, respectively: mean number of decayed, missing and filled teeth (DMFT), and presence of marginal inflammation (gingivitis) or clinical attachment loss (periodontitis). Two independent reviewers conducted all phases of review. Included studies reporting similar outcomes were subjected to random-effects meta-analysis.

RESULTS

From 1,246 retrieved references, 39 were included. Most studies were cross-sectional investigations involving young patients with acute lymphoblastic leukemia. Nine studies presented high risk of bias and were not included on quantitative analyses. All studies in the meta-analysis (n = 14) were conducted with children/teenagers with acute leukemia. Pooled gingivitis prevalence in patients before and during leukemia treatment was 85% (95%CI 75, 97%; 4 studies) and 82% (95%CI 71, 94%; 6 studies), respectively. Pooled DMFT means were 2.28 (95%CI 1.31, 3.25; 7 studies) and 3.65 (95%CI 1.45, 5.86; 5 studies) respectively for patients during and after leukemia treatment. Studies regarding periodontitis prevalence were too few to run a meta-analysis.

CONCLUSIONS

Based on cross-sectional data, young people with acute leukemia have high prevalence of gingivitis and caries experience. These findings indicate that the effect of leukemia on oral health still needs to be better investigated.