Dental consensus on HSCT - Part II: dental Care during HSCT

ABSTRACT During the state of immune vulnerability in hematopoietic stem cell transplantation (HSCT), the patient has an increased risk of developing a vast number of complications, including severe problems in the oral cavity. These situations require professional oral care to act in the diagnosis and treatment of these conditions, as well as to develop prevention protocols to minimize patient's complications. Oral mucositis, opportunistic infections, bleeding, specific microbiota, taste, and salivary alterations are complications that can occur during HSCT and interfere with various aspects, such as pain control, oral intake, nutrition, bacteremia and sepsis, days of hospitalization and morbidity. Several guidelines have been published to address the role of professional oral care during the HSCT, we describe a consensus regarding these recommendations.

Brazilian dental consensus on dental management in hematopoietic stem cell transplantation−Part I−pre-HSCT

ABSTRACT The oral involvement in the Hematopoietic Stem Cell Transplantation is well described in the literature. The goal of the dental treatment and management of the oral lesions related to the HSCT is to reduce the harm caused by preexisting oral infection or even the worsening of oral acute/chronic GVHD and late effects. The aim of this guideline was to discuss the dental management of patients subjected to HSCT, considering three phases of the HSCT: pre-HSCT, acute phase, and late phase. The literature published from 2010 to 2020 was reviewed in order to identify dental interventions in this patient population. The selected papers were divided into three groups: pre-HSCT, acute and late, and were reviewed by the SBTMO Dental Committee's members. When necessary, an expertise opinion was considered for better translating the guideline recommendations to our population dental characteristics. This manuscript focused on the pre-HSCT dental management. The objective of the pre-HSCT dental management is to identify possible dental situations that On behalf of the Dental Committee of the Brazilian Society of Gene Therapy and Bone Marrow Transplantation (SBTMO) can worsening during the acute phase after the HSCT. Each guideline recommendations were made considering the Dentistry Specialties. The clinical consensus on dental management prior to HSCT provides professional health caregivers with clinical setting-specific information to help with the management of dental problems in patients to be subjected to HSCT.

Dentistry consensus on HSCT - Part III: Special topics - Dentistry on HSCT

ABSTRACT Patients undergoing hematopoietic stem cell transplantation (HSCT) might present acute and late toxicities and the oral tissues are frequently affected. With the survival increasing, patients show late and long-term morbidities, and there is an important association between the general and the oral health. The first and second parts of this Consensus have showed the importance of the adequacy of oral health in the pre-HSCT, and the main alterations and oral care during the period of admission for HSCT. This third part aims to review specific themes of post-HSCT dental care, such as graft-versus-host disease (GVHD) and the pediatric patient. It also aims to review pertinent subjects, both during the HSCT period and post-HSCT, concerning quality of life, pain, cost-effectiveness, and remote care. Based on this review, it is evident the importance of the work of the dental surgeon (DS) in the follow-up and treatment of the HSCT patient, always collaborating with the whole multidisciplinary team.

Pacientes portadores de diabetes tipo 2: manifestações sistêmicas e orais de interesse para o atendimento odontológico / Type 2 diabetic patients: systemic and oral manifestations relevant to dental care

Pessoas portadoras de diabetes mellitus (DM) desenvolveram diversas complicações crônicas sistêmicas, como macro- e microangiopatias, nefropatias, neuropatias, hipertensão arterial e outras. Essas alterações muitas vezes se associam a agravos bucais, como xerostomia, periodontite, gengivite, infecções oportunistas e cárie dentária. Além disso, a descompensação glicêmica pode agravar o curso de evolução dessas manifestações bucais e interferir sobre o plano de tratamento odontológico desses pacientes. O presente estudo acompanhou a sistemática de tratamento odontológico de pacientes diabéticos atendidos pelo Centro de Atendimento a Pacientes Especiais da Faculdade de Odontologia da Universidade de São Paulo (CAPE-FOUSP) que foram encaminhados pela Associação Nacional de Assistência ao Diabético (ANAD), com o objetivo de verificar a condição de saúde bucal, as necessidades de tratamento e os tipos de cuidados especiais demandados nesses atendimentos. Foram acompanhados 100 pacientes adultos atendidos no ano de 2000. Foram quantificados indicadores da experiência de cáries, gengivite, periodontite, hipossalivação, uso de prótese, abcesso gengival, queilite angular e candidíase eritematosa nesses pacientes. Além disso, foram registradas manifestações de cardiopatias, hipertensão arterial, alteração glicêmica no momento da consulta e outras alterações sistêmicas relevantes para o atendimento odontológico. O dimensionamento das condições sistêmicas e dos agravos bucais experimentados pelos pacientes diabéticos deve instruir os profissionais da saúde bucal quanto ao tipo de atendimento demandado. Com base nos dados apresentados, preconiza-se que o atendimento odontológico seja precedido por avaliação glicêmica, aferição de pressão arterial e exames clínicos complementares necessários