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Sakai H, Kurita H, Kondo E, Tanaka H, Shimane T, Hashidume M, Yamada SI. Dental and oral management in the perioperative period of surgery: A scoping review. Jpn Dent Sci Rev 2024; 60:148-153. [PMID: 38633513 PMCID: PMC11021219 DOI: 10.1016/j.jdsr.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 02/27/2024] [Accepted: 03/25/2024] [Indexed: 04/19/2024] Open
Abstract
Dental and oral management (DOM) is a long-established treatment modality. This scoping review aimed to narratively review previous studies, examine the effects of perioperative DOM, and identify the available evidence. A literature search was conducted using the PubMed electronic database for studies published between January 1, 2000, and March 8, 2022. The search yielded 43 studies, most of which were published in the last 10 years. The results of this study confirmed that improved perioperative oral hygiene is effective in preventing postoperative pneumonia. Our results also suggested that preoperative DOM is effective in preventing postoperative surgical site infections. Perioperative DOM is effective in reducing the incidence of postoperative pneumonia, SSI, and postsurgical complications. Further studies are needed to elucidate the various mechanism of DOM and to examine efficient intervention methods and timing.
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Affiliation(s)
- Hironori Sakai
- Department of Oral and Maxillofacial Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto-shi, Nagano-ken 390-0872, Japan
| | - Hiroshi Kurita
- Department of Oral and Maxillofacial Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto-shi, Nagano-ken 390-0872, Japan
| | - Eiji Kondo
- Department of Oral and Maxillofacial Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto-shi, Nagano-ken 390-0872, Japan
| | - Hirokazu Tanaka
- Department of Oral and Maxillofacial Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto-shi, Nagano-ken 390-0872, Japan
| | - Tetsu Shimane
- Department of Oral and Maxillofacial Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto-shi, Nagano-ken 390-0872, Japan
| | - Masao Hashidume
- Department of Oral and Maxillofacial Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto-shi, Nagano-ken 390-0872, Japan
| | - Shin-Ichi Yamada
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, 3190 Gofuku, Toyama-shi, Toyama-ken 930-8555, Japan
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Yoshitomi A, Soga Y, Yamanaka-Kohno R, Morimatsu H. Sensitivity and specificity of the question "do you have any concerns regarding your mouth related to undergoing surgery?" for predicting perioperative oral health problems in patients with primary esophageal and lung cancer: a retrospective observational study. Perioper Med (Lond) 2024; 13:36. [PMID: 38711163 DOI: 10.1186/s13741-024-00394-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 04/27/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND Perioperative oral management contributes to the prevention of dental/systemic complications. However, a professional dental checkup before surgery is generally not performed and relies on the patient's answer to a simple question by medical professionals other than dentists: "Do you have any concerns regarding your mouth related to undergoing surgery?" Here, we evaluated the sensitivity and specificity of this question for predicting perioperative oral health problems in patients with primary esophageal and primary lung cancer. METHODS We performed an oral cavity check in all patients before scheduled surgery for primary esophageal and lung cancer. A total of 183 patients were enrolled (M, 112; F, 71; 24-88 years, median, 69 years), consisting of 61 with primary esophageal cancer (M, 46; F, 15; 24-85 years, median, 69 years) and 122 with primary lung cancer (M, 66; F; 56; 33-88 years, median, 69 years). All subjects provided a response to this question, and an oral cavity check was performed by dentists. The sensitivity and specificity of this question for detecting oral health problems were evaluated retrospectively. RESULTS Overall sensitivity and specificity for detecting oral health problems were 0.263 and 0.898, respectively. There were no significant differences by sex or disease (primary esophageal or lung cancer). CONCLUSION This simple question has low sensitivity but high specificity for detecting oral health problems. Although challenging to detect surgical patients with oral health problems by simply asking questions, the results indicated that patients with oral complaints are more likely to have problems during surgery.
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Affiliation(s)
- Aiko Yoshitomi
- Division of Hospital Dentistry, Okayama University Hospital, 2-5-1, Shikata-Cho, Kita-Ku, Okayama, 700-8558, Japan
- Perioperative Management Center, Okayama University Hospital, Okayama, Japan
| | - Yoshihiko Soga
- Division of Hospital Dentistry, Okayama University Hospital, 2-5-1, Shikata-Cho, Kita-Ku, Okayama, 700-8558, Japan.
| | - Reiko Yamanaka-Kohno
- Division of Hospital Dentistry, Okayama University Hospital, 2-5-1, Shikata-Cho, Kita-Ku, Okayama, 700-8558, Japan
| | - Hiroshi Morimatsu
- Perioperative Management Center, Okayama University Hospital, Okayama, Japan
- Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
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Kawajiri J, Nagata K, Nakamura A, Fujieda A, Ino K, Nomura J, Arai N, Ohishi K, Katayama N, Nakase K. Clinical utility of oral management in allogeneic hematopoietic stem cell transplantation recipients: microbiological evidence based on molecular analysis of oral bacteria. Support Care Cancer 2021; 30:757-764. [PMID: 34374846 DOI: 10.1007/s00520-021-06462-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 07/22/2021] [Indexed: 12/01/2022]
Abstract
PURPOSE This study aimed to clarify the clinical utility of oral management to prevent bloodstream infections by oral bacteria microbiologically in patients undergoing allogeneic hematopoietic stem cell transplantation (ASCT). METHODS Ten consecutive patients with hematological malignancies undergoing ASCT were enrolled in this study. We implemented dental treatments before transplantation, if required, and carried out oral hygiene instructions and oral management every other day after transplantation. Molecular analysis of bacterial DNA for seven oral species using a polymerase chain reaction (PCR) assay was performed for oral samples and peripheral blood once a week for 3 weeks after transplantation. RESULTS Periodontitis was found in all 10 patients (mild grade in 3 and middle grade in 7) for whom basic periodontal therapy was conducted. Necessary dental procedures, including tooth extraction were performed in 5 patients. After transplantation, oral mucositis occurred in 10 patients (grade 1 in 3, grade 2 in 2, and grade 3 in 5) for whom oral hygiene instruction and oral care were continued every other day. PCR-identified three to six bacterial species in oral samples from nine patients, but none in peripheral blood from any patient during the observation period. CONCLUSIONS Our study suggests that oral management could prevent bloodstream infections by oral bacteria in ASCT recipients despite the existence of periodontitis or oral mucositis. Its utility was confirmed by microbiological evidence based on molecular data.
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Affiliation(s)
- Jumpei Kawajiri
- Faculty of Nursing, Suzuka University of Medical Science, Mie, Japan.,Department of Translational Medical Science, Mie University Graduate School of Medicine, Mie, Japan
| | - Kokoro Nagata
- Department of Oral and Maxillofacial Surgery, Mie University Hospital, Mie, Japan
| | - Akiko Nakamura
- Central Clinical Laboratories, Mie University Hospital, Mie, Japan
| | - Atsushi Fujieda
- Department of Hematology and Oncology, Mie University Hospital, Mie, Japan
| | - Kazuko Ino
- Department of Hematology and Oncology, Mie University Hospital, Mie, Japan
| | - Jouji Nomura
- Department of Oral and Maxillofacial Surgery, Mie University Hospital, Mie, Japan
| | - Naoya Arai
- Department of Oral and Maxillofacial Surgery, Mie University Hospital, Mie, Japan
| | - Kohshi Ohishi
- Transfusion Service, Mie University Hospital, Mie, Japan
| | - Naoyuki Katayama
- Faculty of Nursing, Suzuka University of Medical Science, Mie, Japan.,Department of Hematology and Oncology, Mie University Hospital, Mie, Japan
| | - Kazunori Nakase
- Department of Hematology and Oncology, Mie University Hospital, Mie, Japan. .,Cancer Center, Mie University Hospital, Mie, Japan.
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Bellot A, Curien R, Derache A, Delaître B, Longo R, Zevering Y, Guillet J, Phulpin B. Oral management in a patient with Gardner-Diamond Syndrome: A case report. Int J Surg Case Rep 2020; 75:367-371. [PMID: 32980710 PMCID: PMC7522574 DOI: 10.1016/j.ijscr.2020.09.098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 09/14/2020] [Accepted: 09/14/2020] [Indexed: 11/28/2022] Open
Abstract
Gardner-Diamond Syndrome is a rare but potentially life-threatening disease. Oral surgery in Gardner-Diamond Syndrome can induce intraoral-facial skin lesions. Concomitant systemic manifestations may also arise. Oral surgery guidelines for Gardner-Diamond syndrome are needed.
Introduction Gardner-Diamond Syndrome (GDS) is rare. It is characterized by the spontaneous formation of painful erythematous skin lesions that develop into ecchymoses within 24 h and then disappear progressively over days to weeks. The complications can be serious. Presentation of case A 35-year-old man with GDS was admitted to the oral surgery department for dental infectious focus eradication. Clinical and radiological examinations indicated extraction of tooth 17. It was performed with local anaesthesia, cardiac monitoring, and verbal reassurance therapy. After delivering anaesthesia, two intra-oral hematomas and a bruise quickly developed. Cardiovascular manifestations and a spontaneous painful right temporal erythematous skin lesion appeared in the next 24 h. The patient was briefly hospitalized in the cardiovascular medicine department. Over the next 21 days, some haematomas regressed, another expanded, and a new cervico-thoracic ecchymosis developed. Discussion The surgical and post-surgical complications in this clinical case raise several points concerning the oral management of patients with GDS. We propose to apply: verbal reassurance therapy during surgery; presurgical haematological evaluation and postsurgical daily haematological follow-up; and atraumatic surgery with intra- and post-surgical haemostatic precautions. Systematic antibiotic prophylaxis and non-steroidal anti-inflammatory drugs may also be useful. Other possibilities include desmopressin acetate, corticosteroids, antihistamines, plasmapheresis, and immunosuppressive agents; however, few cases have been treated with these strategies. Conclusion This case highlights the difficult management of patients with GDS who require oral surgery. Further studies are needed to improve the oral surgical procedures in these patients and to establish a systematic management algorithm.
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Affiliation(s)
- Ambre Bellot
- Department of Oral Surgery, CHR Metz-Thionville, 1 Allée du Château, 57085, Ars-Laquenexy, France; Department of Odontology, CHRU Nancy, Rue du Morvan, 54500, Vandoeuvre-lès-Nancy, France.
| | - Rémi Curien
- Department of Oral Surgery, CHR Metz-Thionville, 1 Allée du Château, 57085, Ars-Laquenexy, France
| | - Anaïs Derache
- Department of Odontology, CHRU Nancy, Rue du Morvan, 54500, Vandoeuvre-lès-Nancy, France
| | - Bruno Delaître
- Department of Odontology, CHRU Nancy, Rue du Morvan, 54500, Vandoeuvre-lès-Nancy, France; Odontology Faculty of Nancy, 96 Avenue du Maréchal de Lattre de Tassigny, 54004, Nancy, France
| | - Raffaele Longo
- Department of Oncology, CHR Metz-Thionville, 1 Allée du Château, 57085, Ars-Laquenexy, France; Clinical Research Support Unit, CHR Metz-Thionville, 1 Allée du Château, 57085, Ars-Laquenexy, France
| | - Yinka Zevering
- Clinical Research Support Unit, CHR Metz-Thionville, 1 Allée du Château, 57085, Ars-Laquenexy, France
| | - Julie Guillet
- Department of Odontology, CHRU Nancy, Rue du Morvan, 54500, Vandoeuvre-lès-Nancy, France; Odontology Faculty of Nancy, 96 Avenue du Maréchal de Lattre de Tassigny, 54004, Nancy, France
| | - Bérengère Phulpin
- Department of Odontology, CHRU Nancy, Rue du Morvan, 54500, Vandoeuvre-lès-Nancy, France; Odontology Faculty of Nancy, 96 Avenue du Maréchal de Lattre de Tassigny, 54004, Nancy, France
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Hasegawa T, Takeda D, Tanaka M, Amano R, Saito I, Kakei Y, Kimoto A, Fukumoto T, Akashi M. Effects of preoperative dental examination and oral hygiene instruction on surgical site infection after hepatectomy: a retrospective study. Support Care Cancer 2021; 29:653-9. [PMID: 32424646 DOI: 10.1007/s00520-020-05525-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 05/09/2020] [Indexed: 01/16/2023]
Abstract
PURPOSE This study retrospectively investigated relationships among risk factors and post-hepatectomy surgical site infection (SSI) and other complications in patients who underwent hepatectomy for hepatocellular carcinoma (HCC). METHODS We included 334 patients who underwent hepatectomies for liver cancers between January 2011 and December 2015 in this study. We evaluated risk factors for SSI and other post-hepatectomy complication, including demographic factors, preoperative factors, and preoperative intervention including oral management, perioperative factors, and length of hospital stay, with univariate and multivariate analyses. The oral management intervention included self-care instructions, extraction of infected teeth, removal of dental plaques and calculus (scaling), professional mechanical teeth cleaning, removal of tongue coating, and cleaning of dentures. SSI was defined in accordance with the guideline issued by the Centers for Disease Control and Prevention; it included purulent discharge from any incision or organ space within 30 days postoperatively, with or without microbiological evidence. Complications of grade II or greater, according to the Clavien-Dindo classification, were regarded as postoperative complications. RESULTS We found bacterial infection of ascites (Odds ratio (OR) = 13.72), lack of preoperative oral management intervention (OR = 10.17), and severe liver fibrosis (OR = 2.76) to be associated with SSI and severe liver fibrosis (OR = 2.28), hypoalbuminemia (OR = 2.02), blood transfusion (OR = 1.86), and longer operation time (OR = 1.80) to be associated with postoperative complications. CONCLUSIONS Preoperative oral management may reduce the risk of SSI in patients with HCC who undergo hepatectomy.
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Kusumoto Y, Imai K, Ohyama Y, Fukayama H, Shinozuka O. Oral management of a patient with down syndrome and agammaglobulinemia: a case report. BMC Oral Health 2020; 20:71. [PMID: 32169066 PMCID: PMC7069031 DOI: 10.1186/s12903-020-1056-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 03/02/2020] [Indexed: 11/21/2022] Open
Abstract
Background Down syndrome is characterized by a variety of dysmorphic features and congenital malformations, such as congenital heart disease, gastrointestinal disease, and other conditions like leukemia and autoimmune disorders. Patients with Down syndrome are highly prone to respiratory tract infections, which might be fatal to them. However, there are only few available data on patients diagnosed with Down syndrome and agammaglobulinemia. In this report, we describe a case of successful prevention of post-dental treatment complications (e.g., pneumonia and other bacterial infections) in a patient with Down syndrome and agammaglobulinemia. Case presentation A 43-year-old man with Down syndrome, untreated agammaglobulinemia, and a history of recurrent pneumonia, was referred to our clinic for tooth mobility. To reduce the risk of post-operative infections, gammaglobulin treatment and prophylactic administration of antibiotics was scheduled before the dental procedure. Furthermore, the dental treatment, which included a filling and extractions, was conducted under general anesthesia and with the supervision of a hematologist. The dental procedures were successfully performed without any post-operative infection, and the patient is undergoing follow-up care. Conclusions The purpose of this case report was to recommend a close liaison between physicians and dentists who may encounter a similar case, and to emphasize the importance of improving oral health of immunodeficient patients to prevent infections caused by oral microbial flora.
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Affiliation(s)
- Yasuka Kusumoto
- Department of Dentistry for Persons with Disabilities, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, Japan.
| | - Kohsuke Imai
- Department of Community Pediatrics, Perinatal and Maternal Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoshio Ohyama
- Department of Oral and Maxillofacial Surgery, Shizuoka City Shizuoka Hospital, Shizuoka, Japan
| | - Haruhisa Fukayama
- Department of Anesthesiology and Clinical Physiology, Graduate School of Tokyo Medical and Dental University, Tokyo, Japan
| | - Osamu Shinozuka
- Department of Dentistry for Persons with Disabilities, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, Japan
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Kawashita Y, Soutome S, Umeda M, Saito T. Oral management strategies for radiotherapy of head and neck cancer. Jpn Dent Sci Rev 2020; 56:62-67. [PMID: 32123547 PMCID: PMC7037635 DOI: 10.1016/j.jdsr.2020.02.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 01/13/2020] [Accepted: 02/02/2020] [Indexed: 12/11/2022] Open
Abstract
Radiotherapy, often with concomitant chemotherapy, has a significant role in the management of head and neck cancer, however, radiotherapy induces adverse events include oral mucositis, hyposalivation, loss of taste, dental caries, osteoradionecrosis, and trismus, all of which have an impact on patients’ quality of life. Therefore, it is necessary to implement oral management strategies prior to the initiation of radiotherapy in patients with head and neck cancer. Since 2014, the National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology (NCCN Guidelines) have enumerated the “Principles of Dental Evaluation and Management (DENT-A)” in the section on head and neck cancers, however, oral management was not explained in detail. Oral management has not been achieved a consensus protocol. The aim of this literature is to show that oral management strategy include removal infected teeth before the start of radiotherapy to prevent osteoradionecrosis, oral care for preventing severe oral mucositis to support patient complete radiotherapy during radiotherapy, and prevent of dental caries followed by osteoradionecrosis after radiotherapy.
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Affiliation(s)
- Yumiko Kawashita
- Department of Oral Management Center, Nagasaki University Hospital, Japan
- Corresponding author at: Department of Oral Management Center, Nagasaki University Hospital, 1-7-1, Sakamoto, Nagasaki-city, Nagasaki 852-8102, Japan.
| | - Sakiko Soutome
- Department of Oral Management Center, Nagasaki University Hospital, Japan
| | - Masahiro Umeda
- Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Toshiyuki Saito
- Department of Oral Health, Nagasaki University Graduate School of Biomedical Sciences, Japan
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