Oral Symptom Management Research Articles

The link between cutaneous allodynia and pain/sensitivity in teeth and gums during migraine episodes

BackgroundMigraine is one of the most common primary headaches worldwide, while toothache is the most common pain in the orofacial region. The association of migraine pain, and oral pain is unknown. This study aims to investigate the association between migraine and dental and gingival pain with the presence of allodynia.MethodsA questionnaire comprising demographic data with the ID-Migraine (IDM) tool, an Allodynia Symptom Checklist (ASC), and inquiries about pain and sensitivity in the teeth and gums during migraine attacks was administered to the participants and 762 responded the survey. The study classified participants based on the ASC, and the relationship between allodynia and pain/sensitivity in the teeth and/or gums during migraine attacks was analyzed. The statistical analyses utilized Chi-square tests and the Fisher-Exact test.ResultsAmong 762 migraine patients, 430 (56.44%) were classified as allodynia (+), while 332 (43.56%) were classified as allodynia (−) (p < 0.001). Additionally, 285 participants (37.5%) reported experiencing pain and sensitivity in the teeth and gums during migraine attacks, with a significant relationship observed between allodynia and pain/sensitivity in the teeth and/or gums during migraine attacks (p < 0.001).ConclusionThe findings of this study have important clinical implications. For migraine patients who are non-allodynic, the presence of pain and sensitivity in their teeth and gums during migraine attacks may indicate underlying dental diseases or the need for dental treatment especially root canal treatment. However, for allodynic patients, such symptoms may not necessarily indicate the presence of dental diseases or the need for dental treatment especially root canal treatment. These results underscore the significance of considering the presence of allodynia in the assessment and management of oral symptoms during migraine attacks.

Erratum to: Oral hygiene care and the management of oral symptoms in patients with cancer in palliative care: a mixed methods systematic review protocol.

Erratum to: Oral hygiene care and the management of oral symptoms in patients with cancer in palliative care: a mixed methods systematic review protocol.

Oral hygiene care and the management of oral symptoms in patients with cancer in palliative care: a mixed methods systematic review protocol.

The objective of this review is to examine the effectiveness of oral hygiene care in the management of oral symptoms in patients with cancer under specialist palliative care and the patients' experience of such symptoms and care. Oral symptoms, such as xerostomia, mouth pain, or dysgeusia, are highly prevalent in patients with cancer under specialist palliative care. These symptoms have a negative effect on patients' quality of life. Oral hygiene care can manage oral symptoms and could be improved with a more systematized approach, adequate guidelines, and training to properly integrate oral hygiene into the care provided in specialist palliative care. This review will consider quantitative, qualitative, and mixed methods studies on the effectiveness and experience of oral hygiene care intended to manage oral symptoms in patients with cancer aged 18 years or older, diagnosed with any type of cancer, under specialist palliative care. The search will be conducted in MEDLINE (PubMed), CINAHL (EBSCOhost), Cochrane Central Register of Controlled Trials, Dentistry and Oral Sciences Source (EBSCOhost), and MedicLatina (EBSCOhost). Sources of unpublished studies and gray literature to be searched will include Networked Digital Library of Theses and Dissertations and Repositórios Científicos de Acesso Aberto de Portugal. Studies in English, Portuguese, and Spanish published from 2000 to the present will be considered. Methodological quality of included studies will be assessed and data will be extracted. Synthesis and integration will follow the JBI segregated approach for mixed methods reviews. PROSPERO CRD42023400554.

Two-year evolution of quality of life following radiotherapy and/or chemotherapy in patients with head and neck cancer

ObjectiveThis study aims to elucidate the trajectory of quality of life (QoL) over a two-year period after radiotherapy and/or chemotherapy for head and neck cancer (HNC), addressing the gap in long-term QoL information. MethodsEmploying a prospective longitudinal observational design, we tracked 58 HNC patients who underwent radiotherapy and/or chemotherapy, analyzing their QoL using Short-Form 36-Item Health Survey version 2 (SF36v2), the European Organization for Research and Treatment of Cancer quality of life (EORTC-QLQ-C30), and the European Organization for Research and Treatment of Cancer quality of life head and neck-35 (EORTC-QLQ-H&N35) questionnaires for two years post-discharge. The data underwent repeated measures analysis of variance. ResultsOver the two-year follow-up, 10 patients (17.2%) succumbed, and 8 (13.8%) dropped out. SF36v2 physical and role-social component summary scores declined during treatment, requiring 1–2 years for recovery. The mental component summary score remained stable. EORTC-QLQ-30 revealed global health status recovery within one year post-discharge. EORTC-QLQ-H&N35 items like “swallowing,” “senses problems,” “trouble with social eating,” “dry mouth,” “sticky saliva,” “coughing,” and “felt ill” worsened pre-discharge. “Trouble with social contact” improved within a year, while “pain,” “swallowing,” “senses problems,” “trouble with social eating,” and “coughing” improved within two years. “Dry mouth” and “sticky saliva” persisted throughout the two-year follow-up, common symptoms of HNC and treatment side effects. ConclusionsRecovery of specific QoL aspects in HNC patients treated with radiotherapy and/or chemotherapy may require up to two years. Prolonged monitoring and management of oral symptoms could enhance QoL. Future research should extend follow-up beyond two years for comprehensive interventions enhancing patient QoL.

Dental Management in the Immunocompromised Children: A Review

Oral manifestations of oropharyngeal infections in immunocompromised individuals pose a unique challenge for medical and dental specialists, as clinical signs and symptoms could be minor, making correct diagnosis and treatment difficult. Effective infection control and oral symptom management are critical, and they can be done by the careful use of topical and systemic medicines, as well as proper oral hygiene. According to current guidelines, children should receive an oral examination before starting cancer treatment. Before the commencement of cancer treatment–related oral issues, a pretreatment examination helps develop a dentist-child relationship. Intensive mouth care is critical because it reduces the chance of developing moderate/severe mucositis while also reducing the risk of septicemia and oral infections. Almost all of the therapy's oral side effects are caused by stomatotoxicity, either direct or indirect. The purpose of therapy for this patient group is to keep the oral mucosa healthy, avoid secondary infection, relieve pain, and maintain nutritional intake. In this narrative review we will be looking at evaluation, prevention and management of dental complications in immunosuppressed children.

Presentation and management of oral symptoms of pemphigus vulgaris: a case report

Presentation and management of oral symptoms of pemphigus vulgaris: a case report

Management of dry mouth: assessment of oral symptoms after use of a polysaccharide-based oral rinse

Salivary dysfunction is associated with a range of oral/dental issues, and management of oral symptoms may improve oral function and overall quality of life. The purpose of this pilot study was to evaluate oral symptoms and function in a xerostomic population after use of a proprietary topical for dry mouth, Moisyn (Synedgen Inc., Claremont, CA), which is a polysaccharide-based product. A pre- and post-test survey was completed by 57 patients with xerostomia. Patients rated their common oral symptoms, based on the Vanderbilt Head and Neck Symptom Survey, before and after 1-week use of Moisyn rinse and spray. Saliva production under resting and chewing stimulation was also assessed. Most patients reported relief from dry mouth symptoms and thick saliva (81.7% and 76.0%, respectively) for more than 30minutes after product use. Statistically significant reductions were found in 15 of 33 oral symptoms. Symptom improvement ranged from 10.7% to 28.4% for thick saliva, 8.4% to 30.6% for pain, 5.5% to 30.4% for dry mouth, and 12% to 21.3% for taste/diet change. Whole unstimulated/resting saliva improved by 100%, and whole stimulated saliva improved by 23.8%. These findings suggest that the product has utility in symptom control in patients with xerostomia and may lead to an increase in saliva production.

ORAL COMPLICATIONS ASSOCIATED WITH IMMUNOSUPPRESSION AND CANCER THERAPIES

The oral manifestations of oropharyngeal infection in immunocompromised patients present a particular challenge for both medical and dental professionals because clinical signs and symptoms may be minimal and accurate diagnosis and appropriate treatment may be difficult. Effective control of infection and management of oral symptoms are important and may be achieved by the judicious use of topical and systemic agents and by maintaining good oral hygiene. Prevention of mucosal breakdown, suppression of microbial colonization, control of viral reactivation, and effective management of severe xerostomia are all critical steps to reduce the overall morbidity and mortality of oromucosal infections in the severely immunocompromised patient.