Abstract
This study aims to evaluate the salivary parameters and cariogenic microbiota of pediatric oncological patients and their correlation with severe oral mucositis (SOM). A preliminary longitudinal study included patients in the age range from 4 to 18 years (n = 26), with diagnosis of primary cancer, who were followed up before and after time intervals of two, five, and ten weeks of induction chemotherapy. Oral mucosa examinations were performed by means of the modified Oral Assessment Guide (OAG) by calibrated examiners (κ > 0.70). Saliva analysis (unstimulated saliva flow (USF), clinical saliva viscosity (CSV), and pH) and microbiological (total Streptococcus (TS) and Streptococcus of the mutans group (SMG)) tests were performed using unstimulated saliva. The data were analyzed by the Wilcoxon and Spearman Correlation tests (α = 5%). The patients were predominantly of the female sex (n = 15; 57.7%), adolescents (n = 15; 57.7%), and patients with hematological tumors (n = 21; 80.8%). SOM was more frequent in the tenth week (n = 7; 28.6%). The values of USF, CSV, pH, TS, and SMG were not changed by the institution of chemotherapy (p > 0.05). These values were correlated with SOM and the time, TS and SMG, and CSV and SMG. The salivary and microbiological parameters investigated did not influence the severity of oral mucositis in the pediatric patients oncological..
Highlights
Childhood cancer is a chronic and degenerative disease that is considered a serious and relevant public health problem [1]
Oral tissues are profoundly affected by International Journal of Dentistry the toxicity of antineoplastic agents producing numerous comorbidities such as mucositis, reduced salivary flow, and opportunistic viral and fungal infections [5]
oral mucositis (OM) manifests clinically 3 to 10 days following the start of chemotherapy; it depends on the kind of cancer and treatment procedure [11]
Summary
Childhood cancer is a chronic and degenerative disease that is considered a serious and relevant public health problem [1]. Ese factors make tissue repair more difficult, increasing remission time, risk of systemic infection, and healing of OM [10] In pediatric patients, these changes may be exacerbated since the synthesis and composition of saliva are physiologically modified during growth (e.g., salivary gland development, bone synthesis and maturation, exfoliation, and dental eruption) [16]. Several studies have been carried out with cancer patients on radiotherapy, but studies evaluating the impact of chemotherapy, the main treatment of childhood cancer, on the quantitative and qualitative aspects of saliva, and cariogenic biofilm and its possible relation with the aggravation of oral mucositis in children and adolescents are limited. Our hypothesis is that there exist critical periods of chemotherapy treatment with a greater impact on the oral cavity and, these modifications (salivary and microbiological) can increase the severity of OM
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