Oral Care Management of Head and Neck Cancer Patients at Hospital Universiti Sains Malaysia: A 7-Year Retrospective Study

ABSTRACT@#Head and neck cancer patients require oral assessment and management prior, during and after cancer treatment to minimise oral complications. Hence, this study aimed to evaluate sociodemographic data, oral health management, oral complications derived from cancer treatment, time frame in completing dental treatment and association between oral management and complications. Purposive record sampling of head and neck cancer patients who completed radiotherapy and/or chemotherapy at Hospital Universiti Sains Malaysia (HUSM) from 2011 to 2017 were reviewed. A checklist was used to record the data and analysed using descriptive statistics and Pearson Chi-square test. A number of 194 patient records were reviewed with majority were Malays (88.1%), males (61.3%) with the mean age of 57.18 years old. Only 21% of the patients had oral assessment prior to cancer treatment. About 84% of the referred patients were dentally fit within 1 month. Mucositis and fungal infections were the most prevalent complications. The relationship between oral assessment prior to cancer treatment and oral complications was not significant (p = 0.134). Despite the insignificant association due to several limitations, oral assessment and management prior, during and after cancer therapy are recognised as crucial for improving quality of life. A standard institutional operating procedure is recommended to improve patient care.

Dental Problems Associated with Radiation Therapy / 대한연하장애학회지

Dental problems associated with radiation therapy are difficult to treat because of the irreversible nature of radiation therapy and permanent tissue damage. Common oral complications include oral mucosa ulceration, xerostomia, and radiation caries. Other oral complications found infrequently are mouth opening limitation and osteonecrosis of the jaw bone. The acute complication of oral ulceration is associated with dysphagia. In addition, delayed complications, such as xerostomia and dental caries, could lower the quality of life, particularly in terms of chewing and swallowing. The treatment of each complication is dependent on the condition and severity. Symptomatic treatment to relieve pain and discomfort is typical for oral complications. Surgical and radical resection is required for the advanced stage of osteoradionecrosis. In this review, oral complications and their treatments are suggested for clinical guidance.

Dental Management in a Patient with Infantile Osteopetrosis : A Case Report with a 7-Year follow-up / 대한소아치과학회지

Osteopetrosis is characterized by impaired osteoclast function and increased bone density. Infantile osteopetrosis is a severe form of the disease and has characteristics such as diffusely sclerotic skeleton, pancytopenia, cranial nerve entrapment, infection susceptibility, and abnormal craniofacial appearance. Patients with infantile osteopetrosis often experience developmental delay, and may have a short life span.A 14-month-old girl with osteopetrosis presented to the department of pediatric dentistry. Incipient caries on deciduous incisors were observed. The patient revisited 4 years of age. Besides medical problems, oral complications such as growth retardation, narrow upper arch, crowding, dental caries, and abnormal tooth development were observed. After consultation with her pediatrician, dental treatments were performed on the deciduous molars under sedation after a prophylactic antibiotic injection. At a periodic follow-up, multiple deciduous teeth were treated and extracted, and oral-rehabilitation with a removable partial denture was initiated.Patient with osteopetrosis are highly susceptible to infection because of their compromised immune system and problems associated with wound healing that lead to osteomyelitis or sepsis development.Active participation in dental care for sugar intake management and proper oral hygiene are obligatory.