Oral Mucositis in Children with Leukemia Undergoing Chemotherapy: A Case Series

ABSTRACT Objective: To report nine cases of pediatric patients with Acute Lymphoid Leukemia (ALL) or Acute Myeloid Leukemia who developed severe oral mucositis (SOM) at the first week of chemotherapy. Material and Methods: The cases were selected from a sample of 105 children followed for 10 consecutive weeks. Hematological and personal data were obtained from the patient's medical records. The oral cavity was examined weekly using the modified Oral Assessment Guide. Results: More of the patients were male (55.6%), had black/brown skin (55.6%), with ALL (66.7%), and the mean age was 5.55. Two patients had values below normal for leukocytes, platelets, and creatinine over the follow-up. However, all patients showed changes in the normality of hematological data in most weeks. The most used chemotherapeutic agents were aracytin, etoposide, and methotrexate, known for their high stomatotoxic potential. Patients had 2 to 6 (mean of 4) episodes of SOM and 4 to 7 (mean of 5.5) episodes of OM. One patient at week 7, one patient at week 5, and one patient at weeks 2 and 10 did not have OM. Saliva (84 times) and lips (44 times) were the most affected items. Conclusion: The patients showed oscillations in the severity of oral mucositis and hematological parameters over the follow-up. All patients were exposed to stomatotoxic drugs during the initial phase of cancer treatment.

Impact of COVID-19 on Oral Healthcare for Oncopediatric Patients: The Setting in a Reference Hospital in Northeast Brazil

Abstract Objective: To describe the impact of the COVID-19 pandemic on dental care provided to pediatric cancer patients assisted in a referral hospital. Material and Methods: This is an observational, retrospective study based on secondary data extracted from worksheets of dental procedures for patients aged between 0 and 19 years assisted in the pediatric oncology sector of a hospital in João Pessoa, PB, Brazil. Dental procedures performed by the interdisciplinary team of researchers from August 2018 to February 2020 (19 months prior to the pandemic) and from April 2020 to October 2021 (19 months during the pandemic) were totaled and compared. A descriptive analysis of the data was performed. Results: There was a reduction of 80.2% in dental interventions implemented in the sector during the pandemic, with the number of procedures decreasing from 6,210 (the period before the pandemic) to 1,229 (during the pandemic). Most procedures in both periods were performed for patients assisted in beds, for whom there was a reduction of care provided for 81.2% from 5,275 to 994 procedures. Dental procedures in the outpatient clinic decreased by 74.9%, from 935 to 235. Conclusion: The COVID-19 pandemic negatively impacted dental care provided to pediatric oncology patients by restricting dental procedures to emergency demands, compromising performance prevention and health promotion actions.

Oral health habits, prevalence of dental caries and dental erosion in adolescents / Hábitos de higiene oral, prevalência de cárie e erosão dentária em adolescentes

ABSTRACT Objective To assess oral hygiene habits, and prevalence of dental caries and erosion in adolescents of Campina Grande, Paraíba, Brazil. Methods Cross-sectional study with random cluster sampling involving 201 15-year-old schoolchildren. Oral health habits were obtained through questionnaire, and socioeconomic data, by means of interviews. The DMFT index was adopted to determine the prevalence of caries and that proposed by O'Sullivan, to assess dental erosion. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 18. A 5% significance level was adopted. Results All subjects reported using toothbrush and toothpaste, 50.7% reported dental flossing, and association was found between sex and use of mouthwash (p <0.05). Regarding dental caries, the mean DMFT was 3.67 and 51.7% had DMFT lower than or equal to 3. For dental erosion, 18.4% of the sample had erosive lesions, predominantly enamel lesions (92%). Conclusion The use of dental floss was low and adolescents revealed unsatisfactory index. The DMF-T value was moderate and lower than that reported for the Brazilian age group. The prevalence of dental erosion was high, with predominance of enamel lesions.

RESUMO Objetivo Avaliar os hábitos de higiene oral, assim como a prevalência de cárie e erosão dentária em adolescentes em Campina Grande, Paraíba. Métodos Estudo transversal, com amostragem probabilística por conglomerado, envolvendo 201 escolares de 15 anos. Os hábitos de higiene oral foram obtidos por meio de questionário, e os dados socioeconômicos por entrevista. Adotou-se o índice CPO-D (Cariados, Perdidos e Obturados) para determinação da prevalência de cárie e o proposto por O'Sullivan, para avaliação da erosão dentária. Os dados foram analisados por meio do Statistical Package for the Social Sciences (SPSS) versão 18. Adotou-se um nível de significância de 5%. Resultados Todos os adolescentes relataram o uso de escova dental e dentifrício, 50,7% reportaram o uso do fio dental, sendo verificada associação entre o sexo e uso de enxaguatório bucal (p<0,05). Em relação à cárie, o CPO-D médio foi de 3,67 e 51,7% possuíam CPO-D inferior ou igual a 3. No tocante à erosão dentária 18,4% da amostra apresentava lesão erosiva, predominando lesões em esmalte (92%). Conclusão O uso do fio dental foi baixo e os adolescentes revelaram possuir índice insatisfatório. O CPO-D foi moderado e abaixo do relatado para a faixa etária brasileira. A prevalência de erosão dentária foi elevada, com lesões predominantes em esmalte.

Assessment of Oral Hygiene Level and Periodontal Condition in Brazilian Adolescents

Objective: To evaluate the oral hygiene level and periodontal condition of adolescents aged 15-19 years and socioeconomic factors. Material and Methods: Cross-sectional study with 630 adolescents from public schools randomly selected in the city of Campina Grande, Brazil. For data collection, a form containing socioeconomic variables and those related to oral hygiene was used. The oral hygiene level was measured through the Simplified Oral Hygiene Index (OHI-S) and periodontal condition was evaluated by the Community Periodontal Index (CPI). Data were descriptively and inferentially analyzed using the chi-square test, adopting significance level of 5%. Results: Adolescents were mostly females (59.5%), aged 16 years (32.4%), non-white (77.8%), with family income lower than US $ 612.00 (55.1%), with parental schooling of up to high school (50%). Periodontal condition showed no significant association with any of the socioeconomic factors (p> 0.05). All participants reported using toothbrush; however, the control of interproximal plaque with flossing was reported by only 44.1%, being higher among females (p = 0.028), and its use has been associated with periodontal status (p = 0.026). The oral hygiene level was satisfactory for 59.7% of adolescents, while CPI showed that only 1.6% of them had healthy periodontium and gingival bleeding (34.4%) and presence of dental calculus (37, 8%) were the most prevalent alterations. Conclusion: Adolescents showed satisfactory oral hygiene condition; however, there was a high prevalence of gingival bleeding and dental calculus. Periodontal condition was associated with flossing; however, association with socioeconomic factors was not observed.

Hábitos de Higiene Bucal e Condição Periodontal de Escolares Adolescentes / Oral Hygiene Habits and Periodontal Status of Adolescent Students

Avaliar os hábitos de higiene bucal e a condição periodontalde escolares adolescentes do município de Campina Grande – PB.Material e Métodos: Pesquisa transversal, quantitativa e descritiva,sendo a amostra probabilística composta por 201 adolescentes com15 anos de idade. Os dados foram coletados através de um formuláriocontendo informações sobre hábitos de higiene bucal e do exameclínico odontológico, cujos parâmetros utilizados foram o ÍndicePeriodontal Comunitário (CPI) e o Índice de Higiene Oral Simplificado(IHO-S). Os dados coletados foram tabulados (dupla digitação) comauxílio do software SPSS® (StatisticalPackage for the Social Sciences– versão 18.0) e analisados por meio da estatística descritiva(distribuições absolutas e percentuais). Resultados: Todos osadolescentes faziam uso da escova dental, 91,5% escovando de 2 a4 vezes ao dia, porém, 49,3% dos indivíduos não fazia uso de fiodental, e 33,8% relataram utilizar enxaguatório bucal. Apesar de teremapresentado IHO-S satisfatório (55,2%), 97% dos pesquisadospossuíam alguma alteração periodontal, sendo o sangramento a maisprevalente (85,6%), seguido do cálculo dental (42,8%). Conclusão: Ébaixa a utilização do fio dental e de enxaguatórios pelos adolescentes,sendo o sangramento gengival a alteração periodontal predominante,apesar de a maioria dos participantes, de acordo com o IHO-S, terapresentado um grau de higiene oral satisfatório...

To assess the oral hygiene and periodontal condition ofadolescent students in the city of Campina Grande, PB. Material andMethods: This was a cross-sectional, quantitative and descriptivestudy, with a probability sample of 201 15-year-old adolescents. Datawere collected through a form containing information on oral hygieneand dental examination. The parameters assessed were theCommunity Periodontal Index (CPI) and the Simplified Oral HygieneIndex (OHI-S). The data were tabulated (double entry) using the SPSSsoftware (Statistical Package for Social Sciences - version 18.0) andanalyzed using descriptive statistics (absolute and percentagedistributions). Results: All adolescents made regular use of toothbrush,with 91.5% of them brushing 2 to 4 times a day. A total of 49.3% ofthem did not use dental floss, and 33.8% reported using mouthwash.Although participants presented satisfactory OHI-S value (55.2%),97% of them showed some periodontal issues, with bleeding being themost prevalent one (85.6%) followed by dental calculus (42.8%).Conclusion: The use of dental floss and mouthwash by adolescentswas found to be low. Gingival bleeding was the predominant periodontalissue, although most participants presented a satisfactory degree oforal hygiene based on their OHI-S...

Ocorrência de injúrias orofaciais em praticantes de esportes de luta / Orofacial injuries in combat sports practitioners

Objetivo: Analisar a ocorrência de lesões orofaciais em praticantes de esportes de luta. Método: Realizou-se um estudo transversal, descritivo-analítico, com abordagem indutiva e técnica de pesquisa a observação direta extensiva. A amostra do tipo não probabilística foi composta por 85 praticantes de esportes de luta matriculados em academias de Campina Grande-PB. Os dados foram coletados mediante a aplicação de um questionário composto por perguntas abertas e fechadas, dicotômicas e de múltipla escolha. As variáveis analisadas foram: sexo, idade, número e tipo de esporte praticado, importância e uso do protetor bucal, tipo de protetor bucal (pré-fabricado, termoplástico ou confeccionado pelo cirurgião-dentista), ocorrência de lesão associada à prática esportiva, região acometida e injúria na cavidade bucal. Os dados foram apresentados por meio da estatística descritiva. Para a análise bivariada utilizou-se os testes Exato de Fisher e Qui-quadrado (p menor que 0,05%). Resultados: A maioria dos atletas eram homens (76,5%), sendo a média de idade de 27,4 anos (±8,7). Quanto ao número de esportes, observou-se que a maioria fazia um único esporte de luta (90,6%). No que concerne ao tipo de esporte, verificou-se um predomínio do boxe (46,2%), seguido do Jiu-Jitsu (25,8%). A quase totalidade dos indivíduos (95,3%) afirmou conhecer a importância dos protetores bucais, porém apenas 41,7% relataram utilizá-lo, durante a prática esportiva existindo diferença estatisticamente significante entre o uso e o sexo do atleta (P=0,023). O tipo de protetor bucal mais utilizado foi o termoplástico (51,4%). Com relação à ocorrência de lesões nas distintas regiões do corpo, 43,5% afirmaram ter sofrido injúrias, existindo associação entre o sexo e a presença de lesão (P=0,002). Lesões na cavidade bucal foram reportadas por 16,5% dos praticantes, sendo todos do sexo masculino, existindo, portanto, associação estatisticamente significante entre o sexo e a presença de lesões na cavidade bucal (P=0,016). Conclusão: Há um predomínio do sexo masculino entre os atletas de esportes de luta, porém nem todos fazem uso dos protetores bucais durante a prática esportiva, apesar da alta ocorrência de injúrias nas regiões da cabeça e face. As lesões na cavidade bucal apresentaram uma baixa frequência nesses desportistas.

Objective: The purpose of this study was to evaluate the occurrence of orofacial injuries among combat sports practitioners. Method: A cross-sectional descriptive-analytical study was conducted in a sample of 85 combat sports practitioners from fitness gyms in the city of Campina Grande, PB, Brazil. The data were collected using a questionnaire applied to the participants and referred to gender, age, type and number of the practiced sports, importance and use of mouthguard, type of mouthguard, occurrence of injuries related to sports practice, affected region, and oral injury. The data were processed by Epi Info 3.5.1 software and presented by descriptive statistics. Fisher's exact and chi-square tests were employed for bivariate analysis (p less than 0.05). Results: Most athletes were men (76.5%) and the mean age was 27.4 ± 8.7 years. The prevailing sports practices were boxing (46.2%) and jiu-jitsu (25.8%). Only 41.7% of the interviewers used a mouthguard during sports practice and there was a statistically significant difference for its use between the genders (p=0.023). Thermoplastic mouthguard was the most frequently used type (51.4%). Occurrence of diverse injuries in different regions of the body was reported by 43.5% of the subjects, with a statistically significant association between gender and presence of injury (p=0.002). Oral injuries were reported by 16.5% of the practitioners, all of them male, with a statistically significant association between gender and presence of oral injuries (p=0.016). Conclusion: Mouthguard is not properly used by combat sports practitioners, in spite of the high rate of injuries in the head and face region. There was a low frequency of oral injuries among these athletes.