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.

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.

Dental and oral management in the perioperative period of surgery: A scoping review.

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.

Metastatic colon carcinoma in the maxilla: Highlighting the importance of perioperative oral management: A case report.

Metastatic colorectal carcinoma involving the maxilla is a rare phenomenon, and existing literature regarding the significance of perioperative oral function management (POM) in managing such cases is limited. In the present case report the clinical details of a 58-year-old male referred to the oral and maxillofacial department for POM. The patient had previously undergone segmental bowel resection due to stage IIIb colon cancer. A comprehensive approach encompassing a thorough medical history, meticulous physical examination, radiographic imaging and immunohistopathology was employed, and a definitive diagnosis of metastatic adenocarcinoma in the left maxillary gingiva originating from a colorectal carcinoma was reached. Additionally, concomitant metastases were detected in the lungs and liver. Despite the daunting prognosis associated with the metastases in the oral cavity, the patient's quality of life exhibited discernible improvements owing to the implementation of palliative care interventions. Notably, this interdisciplinary approach facilitated the patient's survival for over a year. The present case report strongly advocates for the prompt integration of POM in the surgical management of cancer patients with oral manifestations, which can optimize both the quality of life and overall survival.

Feasibility of a nursing guide for the oral management of outpatients with diabetes mellitus.

Support for nurses is necessary to enable them to practice the oral management of patients with diabetes; however, no support for nurses in this context has been reported. The objective of this study was to verify the feasibility of a nursing guide for the oral management of outpatients with type 2 diabetes, aimed at giving nurses the ability to independently practice oral management for patients with diabetes in an outpatient department. Questionnaires were administered to 25 certified diabetes educator nurses from 54 medical facilities. The evaluation and degree of understanding of the guide were assessed using items in the nursing guide. In addition, opinions and impressions about the guide in the form of free responses were requested. Descriptive statistics were calculated for all measured variables, and data gathered from the free responses were divided into categories based on their similarities and differences. The feasibility of the nursing guide was confirmed, and nurses confidently provided education regarding oral management to patients with diabetes using the guide. These results suggest that a guide may improve nurses' knowledge, skills, and confidence in providing patient education and improve the overall practice of oral management. Further improvements based on the opinions of nurses, such as the expression of terms, implementation of checklists for oral assessment, and identification of devices that can be utilized in a shorter time, are needed to facilitate the implementation of the guide into practice by nurses. Supplementary Information: The online version contains supplementary material available at 10.1007/s13340-023-00622-4.

Expanding on the professional role of dental hygienists as key managers of medical-dental and hospital-dental clinic collaboration in a local Japanese hospital without a dentistry department: From a questionnaire survey after a web seminar.

INTRODUCTION: Perioperative oral management (POM) was introduced into the Japanese universal health insurance system in 2012. Collaboration with dental clinics is important for hospitals without a dentistry department. A dental hygienist newly assigned as a member of the patient flow management centre led a seminar to promote collaboration via the web. This study represents the first step to explore the possible role of the hospital-based dental hygienist in the field of regional medical-dental cooperation of POM by assessing their willingness to participate in providing this type of care by a survey. METHODS: The rate of attendees' satisfaction and the current problems of the collaboration for POM were evaluated through a questionnaire survey after the web seminar. RESULTS: All respondents reported satisfaction with the web seminar although it was the first experience of an online seminar for half of the respondents. All hospital dentists, but only 47.8% of dentists working at clinics, had participated in POM. Dental hygienist tended to show greater desire to participate in POM than dentists. All respondents appreciated the role played by the dental hygienist as a key manager of medical-dental collaboration between the hospital and local clinics. CONCLUSION: The hospital-based dental hygienist can play a role in planning and management of web seminars for POM, to raise awareness and promote regional medical-dental cooperation of POM.

Correlation between geriatric nutritional risk index and oral condition in gastric cancer patients.

OBJECTIVES: Nutritional status is a useful prognostic factor in gastric cancer patients. Since oral hypofunction may cause undernutrition, we cross-sectionally investigated whether the Geriatric Nutritional Risk Index (GNRI) is affected by the number of remaining teeth, occlusal support status and denture use. MATERIALS AND METHODS: The participants were 114 patients diagnosed with gastric cancer between April 2017 and March 2020. The stage of gastric cancer, body mass index, albumin level, total lymphocyte count, C-reactive protein level and GNRI were evaluated. The number of remaining teeth was also evaluated, and the occlusion state was determined based on the Eichner classification. The patients were divided into three main groups representing different occlusal states based on the Eichner index and were also categorised based on denture use. RESULTS: The mean age ± standard deviation of the patients was 75.2 ± 5.5 years. The Eichner classification had a significant positive correlation with GNRI. Low GNRI was associated with a poor occlusal state in group C, while a higher GNRI was associated with a stable occlusal state in group A. However, the denture-related groups showed no significant differences in GNRI. CONCLUSION: The GNRI was associated with the occlusal support level but not with denture use.

Effect of perioperative oral management on postoperative bloodstream infection in heart valve surgery patients.

OBJECTIVE: There is a well-known relationship between oral hygiene and infective endocarditis. Epidemiological evidence regarding perioperative oral management (POM) for cancer surgery has been accumulated, but this evidence is not sufficient for cardiac surgery. Therefore, our purpose was to investigate whether POM can prevent postoperative complications in patients undergoing heart valve surgery. SUBJECTS AND METHODS: Using single-arm medical information, we retrospectively enrolled 301 patients who underwent heart valve surgery between April 2010 and March 2019. The patient background was adjusted by the propensity score (PS). We then analyzed the impact of POM on postoperative bloodstream infection (PBSI), postoperative pneumonia, and mortality using PS inverse probability of treatment weighting (IPTW). RESULTS: IPTW revealed that the POM group had a lower incidence of PBSI than the control group, with an odds ratio of 0.316 (p = 0.003). The mortality in the POM group was significantly lower than that in the control group (p = 0.023). Fourteen patients died in the present study and 6 of them were infection-related. CONCLUSIONS: POM was significantly associated with decreased incidence of PBSI and mortality. The results suggest that POM is beneficial for the prevention of PBSI and mortality in patients undergoing heart valve surgery.

Oral management of children/adolescents with ectrodactyly-ectodermal dysplasia-clefting (EEC) syndrome: A scoping review.

AIMS: EEC is a rare syndrome characterized by the triad of ectrodactyly, ectodermal dysplasia, and orofacial clefting, along with other clinical manifestations mainly in hair, skin, and teeth. The present paper aimed to perform a scoping review to collect the most relevant studies and focused on the diagnosis and oral management of EEC syndrome in the pediatric dental setting. This review also pretended to make recommendations and map the gaps in this clinical topic. METHODS: An exhaustive electronic and manual search was conducted in four databases (PubMed, EMBASE, Google Scholar, and Dentistry & Oral Sciences Source/EBSCO) according to previously established eligibility criteria, using different combinations of keywords, MeSH terms, and Boolean operators. Titles, abstracts, and full-text articles were screened and selected by precalibrated reviewers. A data charting was also accomplished for summarizing the overview of the evidence. RESULTS: A total of 37 references were identified, and 32 titles remained after removing duplicates; then, 25 potential full-text articles were carefully reviewed. Finally, 15 relevant and most informative studies were included. Most studies were single clinical case reports. Only one descriptive retrospective study was detected. None randomized clinical trials or comparative observational studies were found. A medical/dental multidisciplinary approach is needed for the management of EEC syndrome. CONCLUSIONS: Diverse dental specialists must be involved. Pediatric dentists must play a principal role in the prevention and treatment of oral diseases; particularly the preservation of the primary and mixed dentitions, trying to achieve normal orofacial growth.

Effects of Perioperative Oral Management in Patients with Cancer.

Perioperative oral management (POM) is used to prevent pneumonia in patients with cancer. However, the factors that expose hospitalized patients to increased risk of developing pneumonia remain unclear. For example, no study to date has compared the incidence of pneumonia in hospitalized patients by cancer primary lesion, or POM implementation, or not. We determined which patients were most likely to benefit from POM and examined the effects of POM on pneumonia prevention and mortality. In a total of 9441 patients with cancer who underwent surgery during hospitalization, there were 8208 patients in the No POM group, and 1233 in the POM group. We examined between-group differences in the incidence of pneumonia and associated outcomes during hospitalization. There was no significant between-group difference in the incidence of pneumonitis, however, patients with lung, or head and neck cancers, demonstrated a lower incidence of postoperative pneumonia. Among patients with lung and pancreatic cancers, mortality was significantly lower in the POM group. POM appears effective at reducing the risk of postoperative pneumonia in patients with certain cancers. Further, mortality was significantly lower in patients with lung and pancreatic cancers who received POM; hence, POM may be an effective adjuvant therapy for patients with cancer.

A Case of X-Linked Hypophosphatemic Rickets with Dentin Dysplasia in Mandibular Third Molars.

X-linked hypophosphatemic rickets (XLH) is a disease characterized by impaired bone mineralization, and its dental features include gingival abscesses and large pulp spaces due to dentin dysplasia. A 20-year-old woman with XLH was referred to oral surgery for extraction of mandibular third molars. She was diagnosed with XLH at approximately 1 year of age and was treated thereafter. There was no history of gingival abscesses, and panoramic radiographic and computed tomographic examinations revealed no evidence of dentin dysplasia. However, histopathological examination of the extracted teeth showed dentin dysplasia, including interglobular dentin. In this XLH patient, dentin dysplasia was revealed histologically even though no obvious abnormality was found on visual and radiographic examinations. These findings suggest that in patients with XLH, oral management must take dentin dysplasia of the permanent teeth into consideration even if the patient's general condition is well controlled with conventional therapy.

An innovative oral management procedure to reduce postoperative complications.

Background: Numerous studies have shown that improving oral hygiene contributes to a reduction in the risk of postoperative complications in patients with head and neck cancer, cardiac disease, and esophageal cancer. However, the beneficial standard for oral management procedures during the perioperative period has not yet been established. Therefore, our aim was to determine whether or not their innovative oral management intervention contributed to a reduction in postoperative complications in lung cancer. Methods: We performed a retrospective analysis of medical records of patients who underwent lung cancer surgery with lobectomy and pneumonectomy at Kyorin University Hospital. Patients were divided into 2 groups: a perioperative oral management intervention group that underwent lung cancer surgery from April 2016 to March 2018 (n = 164), and a control group without oral management that underwent surgery from April 2014 to March 2016 (n = 199). In particular, our oral management procedure emphasized oral mucosa stimulation to induce saliva discharge as in gum chewing, rather than simply using teeth brushing to reduce oral microbiome. Therefore, our oral management procedure is different from traditional oral care. Results: This study demonstrated that our oral management practice was associated with a decline in the occurrence of postoperative pneumonia (odds ratio, 0.184; 95% CI, 0.042-0.571; P = .009), postoperative hospital stay duration (ß coefficient, -4.272; 95% CI, -6.390 to -2.155; P < .001) and Clavian-Dindo classification grade II or above (odds ratio, 0.503; 95% CI, 0.298-0.835; P = .009). Conclusions: We propose an innovative new strategy using their unique oral management procedure to reduce postoperative complications resulting from pulmonary resection.

Number of Bacteria in Saliva in the Perioperative Period and Factors Associated with Increased Numbers.

Perioperative oral management is performed to prevent postoperative complications, but its indication and management method are unclear. This study aimed to investigate salivary bacterial counts pre-and postoperatively, and factors related to increased bacterial count postoperatively. We included 121 patients who underwent surgery under general anesthesia and perioperative oral management. The bacterial count in saliva was determined preoperatively, and first and seventh days postoperatively using the dielectrophoresis and impedance measurement methods. The relationships between salivary bacterial count and various variables were analyzed using one-way analysis of variance, Spearman's rank correlation coefficient, and multiple regression analysis. The salivary bacterial count increased significantly on the first day postoperatively but decreased on the seventh day. Multivariate analysis showed that age (p = 0.004, standardized coefficient ß = 0.283) and xerostomia (p = 0.034, standardized coefficient ß = 0.192) were significantly correlated with increased salivary bacterial count preoperatively. Salivary bacterial count on the day after surgery was significantly increased in patients with a large number of bacterial counts on the day before surgery after preoperative oral care (p = 0.007, standardized coefficient ß = 0.241) and postoperative fasting (p = 0.001, standardized coefficient ß = -0.329). Establishing good oral hygiene before surgery and decreasing salivary bacterial count are necessary in patients with a high risk of postoperative surgical site infection or pneumonia, especially in older adults or postoperative fasting.

Perioperative Oral Management Prevents Complications of Heart Valve Surgery.

OBJECTIVES: The effect of perioperative oral management on the prevention of postoperative complications remains unclear in cardiac surgery. Exploratory factor analysis was performed to examine whether a lack of perioperative oral management was associated with postoperative complications of heart valve surgery. MATERIALS AND METHODS: We retrospectively enrolled 365 patients who underwent heart valve surgery between April 2010 and March 2019. We extracted data on patient characteristics and set postoperative pneumonia and postoperative bloodstream infection as outcomes. A logistic regression analyses were performed to examine the effect of factors on the incidence of postoperative complications. RESULTS: Significant risk factors for postoperative pneumonia included dialysis, long operative time, and long-term intubation. Similarly, risk factors for postoperative bloodstream infection were long-term intubation and lack of perioperative oral management. Subsequently, we identified the risk factors for long-term intubation, which were common to both complications, and found they were emergency status, combined valvular disease, long operative time, and lack of perioperative oral management. CONCLUSIONS: We demonstrated that a lack of perioperative oral management could be a risk factor for postoperative bloodstream infection and long-term intubation in heart valve surgery. The results suggest that perioperative oral management is effective in preventing postoperative complications of heart valve surgery.

Nurses' knowledge, attitude, and practice regarding oral management for outpatients with type 2 diabetes: a national survey on certified diabetes educators.

The association among certified diabetes educator nurses' knowledge, attitudes, and practices related to oral management has not been well examined. The aim of this study was to examine the association between knowledge and attitude as variables for nurses' practice of oral management as certified diabetes educators at medical facilities in Japan. The questionnaires were administered to 300 certified diabetes educator nurses from 1277 medical facilities. The items regarding knowledge, attitude, and practice of oral management were assessed using items from the guidelines, reports, and books on diabetes and periodontal disease, as well as the exhaustive findings of previous studies. More than 70% of the participants did not practice adequate oral management. Logistic regression analysis revealed that all the items were negatively associated with nurses' confidence in oral management (Factor 1: odds ratio [OR] = 0.55; 95% confidence interval [CI] 0.37-0.83; Factor 2: OR = 0.35; 95% CI 0.18-0.70; Factor 3: OR = 0.38; 95% CI 0.24-0.61; Factor 4: OR = 0.29; 95% CI 0.18-0.49). The practice of oral management coupled with an explanation regarding periodontal disease as a diabetic complication (OR = 2.67; 95% CI 1.01-7.02), and supporting collaboration with multiple medical departments (OR = 2.65; 95% CI 1.24-5.65) were positively associated with nurses' education. These results suggest that more strategies for nurses' education are needed to understand the importance of oral management practices and to improve knowledge, attitudes, and confidence in patient oral management.

What does oral care mean to society?

Oral care is defined in a narrow sense as cleaning of the teeth, oral cavity, and dentures, and in a broad sense as the maintenance of oral functions (feeding, swallowing, chewing, speech, aesthetics, etc.), dental treatment, feeding and swallowing training, and articulation training. In the past, it was recognized as simply cleaning the mouth, but the concept of oral care has gradually expanded, and many studies and surveys have been conducted in cooperation with various other professions. As a result, oral health care is involved not only in the prevention of pneumonia, but also in the onset and suppression for severity of diabetes, cardiovascular diseases, some malignant tumors, cerebrovascular diseases, rheumatoid arthritis, dementia, etc. It is also a powerful supportive therapy in cancer treatment. In the terminal stages of life, oral health care can help people to maintain their dignity by continuing to consume food orally until the end of their lives, and in times of disaster, oral health care has been found to be as important as attention to deep vein thrombosis. It has also been found to be effective in preventing severe diseases such as COVID-19. And, although it has not been discussed much, it has been found to have medical and economic benefits such as reducing the duration of hospitalization and treatment costs. This article reviews the results of research to date.

The preventive effects of perioperative oral care on surgical site infections after pancreatic cancer surgery: a retrospective study.

PURPOSE: Pancreatic ductal adenocarcinoma (PDAC) is the most malignant cancer of the gastrointestinal system, and is associated with high rates of postoperative complications, including surgical site infections (SSIs). Perioperative oral care is an effective measure for preventing postoperative pneumonia. However, the preventive effects of perioperative oral care on SSIs have not been reported. We investigated the preventive effects of perioperative oral care on SSIs after pancreatic cancer surgery. METHODS: A total of 103 patients with PDAC who underwent radical resection at Hiroshima Prefectural Hospital (2011-2018) were enrolled in this retrospective study. Of the 103 patients, 75 received perioperative oral care by dentists and dental hygienists (oral care group), whereas 28 did not (control group). Univariate and multivariate analyses with propensity score as a covariate were used to investigate the incidence and risk factors of SSIs in the oral care and control groups. RESULTS: The incidence of SSIs was significantly lower in the oral care group than in the control group (12.0% vs. 39.3%, P = 0.004). Logistic regression analysis revealed that a soft pancreas, the surgical procedure (pancreaticoduodenectomy), blood transfusion, diabetes mellitus, and the absence of oral care intervention were risk factors for SSIs. The odds ratio for the absence of oral care intervention was 6.090 (95% confidence interval: 1.750-21.200, P = 0.004). CONCLUSION: Our results suggest that perioperative oral care may reduce the risk of developing SSIs after pancreatic cancer surgery. These findings need to be evaluated in future prospective studies. TRIAL REGISTRATION: UMIN registration number: UMIN000042082; October 15, 2020, retrospectively registered.

Clinical utility of oral management in allogeneic hematopoietic stem cell transplantation recipients: microbiological evidence based on molecular analysis of oral bacteria.

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.

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.

Relationship between Oral Bacterial Count and Postoperative Complications among Patients with Cardiovascular Disease Treated by Surgery: A Retrospective Cohort Study.

In this retrospective observational study, we evaluated the relationship between perioperative oral bacterial counts and postoperative complications in cardiovascular disease (CVD) patients. From April 2012 to December 2018, all patients scheduled for surgery received perioperative oral management (POM) by oral specialists at a single center. Tongue dorsum bacterial counts were measured on the pre-hospitalization day, preoperatively, and postoperatively. Background data were collected retrospectively. Among the 470 consecutive patients, the postoperative complication incidence rate was 10.4% (pericardial fluid storage, n = 21; postoperative pneumonia, n = 13; surgical site infection, n = 9; mediastinitis, n = 2; and seroma, postoperative infective endocarditis, lung torsion, and pericardial effusion, n = 1 each). Oral bacterial counts were significantly higher in the pre-hospitalization than in the pre- and postoperative samples (p < 0.05). Sex, cerebrovascular disease, and operation time differed significantly between complications and no-complications groups (p < 0.05). Multivariate analysis with propensity score adjustment showed a significant association between postoperative oral bacterial count and postoperative complications (odds ratio 1.26; 95% confidence interval, 1.00-1.60; p = 0.05). Since the development of cardiovascular complications is a multifactorial process, the present study cannot show that POM reduces complications but indicates POM may prevent complications in CVD patients.

Effect of Cancer Treatment on the Worsening of Periodontal Disease and Dental Caries: A Preliminary, Retrospective Study.

PURPOSE: To investigate the effect of cancer treatment on the worsening of dental caries and periodontal disease. MATERIALS AND METHODS: Fifty-three adult cancer patients who underwent panoramic radiography before cancer treatment and 1-2 years later were enrolled in this study. They received professional oral care, including oral hygiene instruction, scaling and root planing, professional mechanical tooth cleaning, and dental treatment or extraction of any tooth with the source of infection. Age, sex, smoking habit, probing pocket depth, alveolar bone loss, oral hygiene, number of teeth, leukocytes, haemoglobin, and albumin counts, cancer treatment, the administration of immunosuppressants, worsening of dental caries, and alveolar bone loss after 1-2 years were examined. Factors related to the worsening of dental caries and alveolar bone loss were analysed using logistic regression analysis. RESULTS: Dental caries and periodontal disease worsened in 20.8% of the patients. Smoking habit and chemotherapy were independent risk factors for the worsening of dental caries, while alveolar bone loss greater than 1/3 and chemotherapy were independent risk factors related to worsening periodontal disease. CONCLUSION: Anticancer drug treatment is an exacerbating factor for dental caries and periodontal disease.