Oral Health Providers Research Articles

Strategies for managing dental care for refugee patients.

To outline key factors that contribute to oral health issues of refugees and asylum seekers and provide management strategies for dental providers to teach desensitization and fear reduction for this special population. We researched published literature in the PubMed database and incorporated lessons gained from treating refugee and asylee patients at a Vulnerable Populations Clinic (VPC) at an urban academic dental school. Refugees and asylees are at high risk for oral conditions due to a tendency to not seek routine dental treatment, psychological stressors, and various systemic factors. Oral healthproviders can teach patients desensitization and fear reduction by working to gain patients' trust by having effective communication and prioritizing comfort in the dental operatory. Providers should also utilize translation, psychological, and/or multicultural support services during their management of care. By having a stronger understanding of the key causes of oral health issues among refugees and asylees in the United States, dental providers can better approach managing care for this vulnerable patient population. The concepts of teaching desensitization and fear reduction utilized for this special population can be applied to managing care for the wider special needs patient community.

A Clinical Competency Framework for the Basic Package of Oral Care: Perceptions of Primary Oral Health Providers in Rural Nepal.

IntroductionThe basic package of Oral Care (BPOC) was developed to improve oral health care for underserved populations worldwide. However, systematic delivery of the BPOC has been difficult to achieve, and training efforts have in some cases contributed to proliferation of malpractice. Standard Competency Frameworks (CF), increasingly used in dental and medical education to improve quality assurance, have not been established to date for the BPOC.MethodsTo evaluate provider perceptions of a BPOC-specific CF, in-depth interviews were conducted with 7 Primary Oral Health Providers (POHPs) and 5 Clinic Assistants working in the Jevaia Oral Health Care project (Jevaia) in Nepal. Participants were limited to providers who have used the CF. Interviews were audio recorded, transcribed in Nepali, and translated into English. A qualitative thematic analysis was applied through a multi-stage review process, and emergent themes were further grouped and categorized to draw final conclusions.ResultsFindings were categorized into four groups: (1) “What is the CF to Me”: Respondents frequently conflated the CF with professional development training. These activities together were essentially felt to offer clear performance guidance and a pathway for learning. (2) “Relationship to the Work”: Respondents reported that the CF's guidelines increased confidence, peer accountability, and job satisfaction. (3) “Practical Improvements”: Providers felt the CF improved their clinical skills, communication, crowd management, and teamwork. (4) “Community Impact”: Many participants felt that improved skills had led to a more efficient workflow, greater community acceptance, and increased utilization of services.ConclusionsClinicians broadly felt that the CF improved both their professional satisfaction and the quality of patient care. CFs should be considered integral to BPOC implementation, along with opportunities for continuous professional learning, and these activities will likely be most meaningful and impactful when recognized by government and other licensing bodies.

Detecting cracks in teeth and monitoring structural integrity over time with non-invasive PTR-LUM technology a solution for a major clinical challenge

Detecting cracks in teeth is a long-standing clinical challenge. Patients may complain of diffuse pain on chewing, pain, at times, on temperature change and pain that occurs episodically. Common diagnostic tools such as radiographs and visual examination may not detect cracks. This clinical case study shows how photothermal radiometry and luminescence (PTR-LUM), technology behind the Canary Dental Caries Detection System can detect and monitor cracks clinically as well as quantify the extent of crack. This important clinical feature is not yet available with other caries detection clinical devices. In this clinical situation, the cracks involved a large part of the mesial and distal of a mandibular second molar and the adjacent first molar. It led to a diagnosis of parafunction and placement of a mandibular flat plane bite splint along with the placement of composite restorations to restore the fractures. The science behind the point scan lock-in signal processing results of PTR-LUM technology implemented in The Canary System to clinically detect visible cracks or cracks beneath the enamel surface as well as caries on all tooth surfaces and around restorations is discussed. Amplitude and phase results from PTR-LUM point scans are incorporated into a Canary number output developed for oral health providers and are disclosed for the first time in detail with clinical evidence.

Oral Health Service Access in Racial/Ethnic Minority Neighborhoods: A Geospatial Analysis in Washington, DC, USA.

Previous studies on individual-level variables have improved our knowledge base of oral health service use. However, environmental or contextual variables are also important in understanding oral health disparities in racial and ethnic neighborhoods. Based on Bronfenbrenner’s ecological framework, this study examines the geographic availability of oral health providers in Washing-ton DC, U.S.A. Census tract-level data were drawn from the American Community Survey, joined with tract-level shapefiles, and overlaid with the geographic location of dental services throughout the city. Visual maps, descriptive statistics, and spatial lag regression models showed that census tracts with higher concentrations of African Americans were significantly farther from their nearest oral health providers (r = 0.19, p < 0.001), after controlling for neighborhood poverty rate, median age, and gender. Such findings confirm that in urban areas with highly di-verse populations such as Washington DC, racial disparities in oral health care access are signifi-cant. The study highlights that identifying neighborhoods with limited oral health care providers should be a priority in diminishing racial disparities in oral health service access. Improving access to racial/ethnic minority communities, especially African American neighborhoods, will require changes in health policies and programs, workforce development, resource allocation, community outreach, and educational programs.

ACCESS TO ORAL MEDICINE: PERCEPTIONS OF WASHINGTON STATE DENTAL PROVIDERS ON USING TELEHEALTH TO DELIVER ORAL MEDICINE SPECIALTY TREATMENT TO THEIR PATIENTS

<h3>Objectives</h3> Telehealth has provided increased specialty access to patients and health care providers; however, it is currently being underutilized to deliver oral medicine. In this study, we aim to assess the telehealth-related perspectives of licensed oral health providers in the state of Washington and their likelihood to utilize telehealth for oral medicine services. <h3>Study Design</h3> A cross-sectional, confidential, online survey study was performed with data collected via REDCap. Emails were distributed to 8427 licensed dentists and dental hygienists provided by the Washington State Department of Health public records. Analyses included descriptive statistics, means and standard deviations, as well as a hierarchical multiple regression modeled by the Capability, Opportunity, Motivation and Behaviour (COM-B) system of the theoretical domains framework. <h3>Results</h3> Among the 927 participants who initiated the survey (11% response rate), 563 (57%) were included in the analysis based on level of completeness. Dental providers indicated a significant lack of adequate access to oral medicine services (mean [M]= 2.16, standard deviation [SD] = 1.70 on a scale from 1 to 5, with 5 indicating <i>strong agreement</i>) and a significant likelihood to use telehealth to deliver oral medicine (adjusted: M = 71.30, SD = 25.38 on a 100-mm VAS scale, with 100 being <i>very likely</i>). Within the capabilities, opportunity and motivation domains, motivation was the domain most strongly associated with higher likelihood to use telehealth to deliver oral medicine <h3>Conclusions</h3> We identified oral health providers' lack of access to oral medicine in Washington State and their willingness to use a telehealth program to deliver oral medicine. Benefits and barriers indicated by providers in this survey may inform the development of a telehealth program where a multidisciplinary team can support other dental providers in the integrated delivery of oral medicine to their patients across Washington State.

Oral manifestations of Chediak-Higashi syndrome: A systematic review

Chediak-Higashi syndrome (CHS) is an autosomal recessive disorder characterized by leukocytes with giant secretory granules and a myriad of clinical features. However, it is unknown whether oral lesions are part of the syndrome or are refractory to systemic treatment. Herein, we integrated the available data published in the literature on the oral manifestations of individuals with CHS. Searches on PubMed, Web of Science, Embase, Scopus, and LILACS were conducted to identify studies published up to March/2022. The Joanna Briggs Institute tool was used for the critical appraisal of studies. Fourteen articles (21 cases) were detected. The mean age of individuals was 15.9±8.8 years. There was a slight predominance of males (52.4%). The major manifestation was periodontal disease (81%), although ulceration of the oral mucosa (14.3%), gingival/labial abscess (4.8%), and periodontal abscess (4.8%) were also reported. Oral rehabilitation including dental implants (9.5%) was performed after tooth losses due to the poor prognosis of periodontal therapy. CHS is usually diagnosed in an early stage due to its systemic manifestations such as classic oculocutaneous albinism, recurrent infections, and a propensity for bleeding. Oral health providers should be aware of the manifestations of individuals with CHS. Special care, including oral prophylaxis, is indispensable.

Age of First Oral Health Examination and Dental Treatment Needs of Medicaid-Enrolled Children.

Early childhood caries (ECC), despite being preventable, remains the most prevalent disease of childhood, particularly in children between the ages of 2 and 5 y. The association between the type of health care provider completing initial oral health examinations and subsequent dental caries in children under 6 y of age is unclear. The objective of the current study is to longitudinally assess the association between age at first oral health examination and provider type at first oral health examination on dental treatment for children under 6 y of age. Deidentified administrative claims data were used from the IBM Marketscan Multi-State Medicaid Database (n = 2.41 million Medicaid-enrolled children younger than 6 y in 13 states from 2012 to 2017). A Kaplan-Meier survival analysis was used to examine the association between age at first oral health examination and provider type with first treatment of dental caries at follow-up. The adjusted hazard ratio (HR) of dental caries for children whose first oral health examination at 4 y of age is 5.425 times higher than for children whose first oral health examination was before 1 y of age (95% confidence interval [CI], 5.371-5.479). The adjusted HR of dental caries for children seen by pediatric dentists (HR = 1.215; 95% CI, 1.207-1.223) and physicians (HR = 2.618; 95% CI, 2.601-2.635) was higher than those seen by a general dentist. Findings from this study highlight the importance of children having their first oral health examination no later than 12 mo of age in accordance with existing guidelines and referrals from physicians to prevent the need for invasive treatment. Results of this study emphasize the need for a child's first oral health examination to be completed no later than 12 mo of age to prevent dental caries. Reinforcement and referrals by physicians based on this recommendation facilitate early establishment of a dental home in young children.

Factors Associated with Participation in Research Activities among Oral Health Providers in Jazan, Saudi Arabia: A Cross-sectional Study

This study aimed at quantifying participation in dental research-related activities reported by the Saudi Ministry of Health-associated oral healthcare providers in Jazan and to investigate its association with sociodemographic and professional characteristics, as well as practitioners' perceptions of the Research and Development (R&D) index. An online cross-sectional questionnaire was sent to oral health providers in Jazan using a convenience sampling technique. The questionnaire collected data on demographic characteristics and the 16 items of the R&D index. One-way ANOVA and t-tests were used to establish factors associated with R&D index scores. Multiple regression analyses with adjusted effects were conducted to identify the significant predictors for the factors associated with participation in dental research. In total, 113 study participants completed the questionnaire with a response rate of 56.5%. Just over half (53.1%) of the participants were working in primary healthcare centers, and 46.9% were working in hospitals. Most of the study samples were dentists (92.0%), while a small percentage were dental hygienists (4.4%) and assistants (3.4%). The sample's participation in dental research was low with a mean of 3.57 (standard deviation = 3.69). The R&D support (p<0.001) and intentions (p = 0.050) significantly predicted the providers' participation in dental research. The current study found that R&D support and intention significantly predicted the providers' participation in dental research. Hence, it is recommended that comprehensive educational and training programs on dental research be developed that focus on the increase and implement it in their practice. This study provides insights into factors and obstacles that influence dental research, which may be useful for future investigations.

Does Education in Oral Health Competencies in Physician Assistant Education Programs Translate to Delivery of Oral Health Services in Clinical Practice?

The purpose of this study was to determine the extent to which physician assistants (PAs) are educated in oral health competencies and the relationship of education to providing oral health services to patients. The study was conducted in 2016 by administering an Internet-based survey to a nationwide sample of 2014 graduates of programs accredited by the Accreditation Review Commission on Education for the Physician Assistant. The survey response rate was 12.7% (N = 304). More than half of the PAs who received education in oral health in their professional education programs indicated that oral health curricula were either integrated into one or several topical areas in the base curriculum or delivered in stand-alone lectures. The majority of PA respondents rated their educational preparation as good or excellent in helping them provide oral health education to their patients (54.8%), make appropriate referrals to oral health providers (53.7%), and provide preventive oral health services (51.2%), while more than 40% rated their preparation as good or excellent in helping them identify oral diseases, conditions, and intervention strategies. More than one-third (35.7%) of all PA respondents reported that they provided oral health services in their clinical practices. PAs who received instruction in oral health competencies through the PA education curriculum or from other sources were 2.82 times more likely to provide oral health assessment and screening services to their patients (95% confidence interval, 1.19-6.67). The PA respondents' provision of oral health services was also significantly associated with working in primary medicine or urgent care practice specialties but not with the work setting. PAs educated in oral health competencies are more likely to provide such services to patients, especially in primary medicine or urgent care settings.

Work and health characteristics of oral health providers who stay healthy at work – a prospective study in public dentistry

Objectives Research into work-related factors that positively influence Oral Health Providers (OHPs) health is scarce. This study aimed to analyse which OHPs in dental services remain healthy over time in relation to work- and health-related factors. Methods OHPs took part in this prospective cohort study (n = 168). In 2012 and 2014 they answered a questionnaire featuring questions about demographics, health indicators, work and organisational factors. Results OHPs were classified into three subgroups; healthy group (n = 66), semi-healthy group (n = 45) and unhealthy group (n = 57). The healthy group reported no sick leave or sickness presence in 2012 or 2014. Factors that explained a greater likelihood of belonging to the healthy group were: good work ability, not having neck pain, perceived low exertion at the end of the working day, not having sleeping problems. They scored higher on health indicators than OHPs in the unhealthy group. Conclusions OHPs with no sick leave or sickness presence report much better salutogenic health, better physical work ability and lower perceived exertion at the end of their workday compared with unhealthy group of OHPs. Understanding the relationship between working conditions and well-being is crucial to target interventions for OHPs which improve work conditions and health.

COVID-19 PANDEMIC AND PERSPECTIVE CONVERGENCE WITH PERIODONTAL DISEASES

This review aim to discuss the important components of Coronavirus Disease (COVID-19) and possible correlations, interactions with oral/periodontal structures. With the beginning of the announcement of the transformation of COVID-19 from an epidemic into a pandemic, it was necessary to realize the injury of several million people infected with this disease and others will become infected soon and its impact on public health as well as the adverse effect of chronic diseases and their causes for the spread of COVID-19. Chronic periodontal diseases are one of the most widespread diseases around the globe and one of their supposed causes is the presence of many microbial plaques, including bacteria and viruses. Presence of coronavirus receptors on the cells of the oral mucosa, and cells of the periodontal pockets, may give a way to adhere the virus and spread inside the body through the periodontium. SARS-CoV-2 virus was found in some saliva samples. A conceivable relevance between periodontitis and COVID-19 has been hypothesized. Defense against COVID-19 in dental clinical consist of three ascending levels. It is advised to utilize a mouth rinse against SARS-CoV-2. At end of this review, oral health providers and periodontists will gain essential knowledge to the successful confrontation against the Coronavirus Disease (COVID-19).

Influence of upper lip curvature on smile attractiveness in patients with different degrees of gingival smiles: A cross-sectional study with opinions from oral health providers and laypersons

Although there is relative consensus about approaches to gingival smile management, there are still discrepancies as to whether a gingival smile is attractive or not. The purpose of this study was to quantify the influence of upper lip curvature shape and the amount of gingival display on the perception of smile attractiveness assessed by Peruvian orthodontists, dentists, and laypersons. A frontal photograph was digitally altered to generate 3 types of upper lip curvature shapes (upward, straight, and downward) with 5 different levels of gingival smile exposure (0mm, 2mm, 3mm, 4mm, and 5mm). Fifteen images were generated. Three groups of evaluators (50 dentists, 50 orthodontists, and 50 laypersons) assessed the images using a visual analog scale. One-way analysis of variance with Bonferroni post-hoc tests and multiple linear regressions were applied. The downward lip curvature shape had a negative effect on the esthetic evaluation of the smile with gingival exposures of 3mm or more for all the evaluating groups (approximately 20-30 points less than upward or straight smile curvature shapes, P<0.05). Laypeople gave higher scores of almost 10 points more than dentists and orthodontists when evaluating the upward lip curvature shape with 5mm of gingival exposure during smile (P=0.029). We found that upward or straight upper lip curvature shapes have a positiveimpact on perceived smile esthetics. In contrast, downward upper lip curvature shapes have a negative effect on perception when evaluating different degrees of gingival smiles.

Evaluating network adequacy of oral health services for children on Medicaid in Arizona.

PurposeInadequate networks can prevent patients from being able to see the providers that they trust and depend upon, especially for children insured through Medicaid. To improve our understanding of poor oral health care outcomes, we conducted a test of network adequacy among Medicaid pediatric dental providers in Arizona through a “secret shopper” phone survey.MethodsThis study tested multiple components of children's access to oral health care, including reliability of provider directory information, appointment availability at the practice level for children covered under Medicaid versus commercial insurance, and compliance with regulatory standards. We contacted individual providers, following a standardized script to schedule a routine appointment on behalf of a 5-year-old patient enrolled in either a Medicaid or commercial plan. We documented the time until the next available appointment, if the practice was reached, and if the practice accepted the specified insurance plan.ResultsWe identified, catalogued, and attempted to call a total of 185 unique practices across Arizona. In four counties, we were unable to identify a single pediatric oral health provider through health plan directories. We observed minimal differences in appointment wait times between callers with commercial insurance and those insured through Medicaid.ConclusionsOur findings underscore the need to improve the accessibility of pediatric health services, especially in rural regions. Facilitating access to routine and recommended oral health screenings for children enrolled in Medicaid is imperative to appropriate stewardship and fulfilling our commitment to provide this vital public health resource.

An Innovating Tool to Enhance the Oral Health of Older Adults With or Without Dementia Through the 4Ms Model

Oral health of the elderly is the most neglected area of healthcare by many providers across healthcare disciplines. Often due to lack of Medicare funding and affordability of the elderly that leads to a constant high cost of non-traumatic dental related emergency department visits. By 2030, the number of adults in the USA will increase to 74 million. Over 22 million (30%) of older Americans will need specialized geriatric care. Simultaneously, in 2025, a national shortage of medical geriatricians will be close to 27,000 full time positions. This shortage has a greater impact on oral health often due to limited access, affordability and shortage of trained dentists to manage patients with special needs, particularly those with cognitive declines. There is an urgent need for an innovation for workforce enhancement nationwide. Innovation that can create a network of age-friendly dental clinics could be based on the 4Ms model-Mentation, Mobility, Medication, and Matters most. Project ECHO is a telementoring guided practice model that revolutionizes health education and increases workforce to provide best-practice specialty care by reducing health disparities. By utilization of the Project ECHO among community dentists, this makes transformation richly effective. Training oral health providers for utilizing the project ECHO model is a logical response for the shortage and to increase oral health access. Project ECHO trains general dentists & dental hygienists to provide specialty care services. Meaning the elderly can obtain the care they need in the right place, at the right time, with better treatment outcomes and reduces costs.

A Qualitative Study of Health Care Providers' Views on Integrating Oral Health into Prenatal Care.

Providing preventive oral health during prenatal care is a recognized strategy for improving pregnant women's access to oral health care. This study sought to qualitatively explore the views of health care providers in British Columbia (BC), Canada, on strategies for integrating preventive oral health into prenatal care. Twenty-four purposefully selected health care providers (13 oral health and 11 prenatal care providers) in Vancouver and Surrey BC participated in audio-recorded semistructured interviews. Interviews lasted from 31 to 61 min, were transcribed verbatim, and were analyzed using an inductive thematic analysis with N-Vivo software. Study validity was ensured via memoing, fieldnotes, member checking, and external audit. Thematic analysis revealed 5 major themes: perception of integrated care, relevance of integrated prenatal oral health, strategies for achieving integrated prenatal oral health, drivers of the integration process, and barriers to integrating oral health during pregnancy. Interprofessional collaboration based on information sharing and communication was identified as a critical factor for integrated care. Oral health checks should be a component of prenatal assessments for achieving integrated prenatal oral health. Participants recommended that prenatal providers should offer oral health education and use screening questions to identify the pregnant woman's oral health needs. The establishment of referral systems was advocated, while dental assessments and oral prophylaxis via the medical services plan were proposed. The inclusion of dental providers in prenatal teams and educating health care providers on interprofessional collaboration were also supported. Oral health and prenatal providers in BC are positively disposed to adopting integrated preventive prenatal oral health care based on interprofessional collaborative practices. The inclusion of oral health providers in prenatal teams was suggested. The results of this study can be used by policymakers for advocacy and decision making when planning care delivery programs for women during pregnancy. Including the suggested strategies could lead to increased access to, and utilization of, oral health services among pregnant women.

Fear control and danger control amid COVID-19 dental crisis: Application of the Extended Parallel Process Model.

There is high risk of contamination with COVID-19 virus during routine dental procedures and infection control is crucial. The aim of this study was to determine the factors associated with Covid-19 preventive behaviors among oral health care providers using an extended parallel process model (EPPM). In a cross-sectional study, short text message invite surveys were sent to 870 oral health care providers in west part of Iran. Data were collected through validated self-report EPPM questionnaires. Descriptive statistics, Chi-square and Fishers exact tests were used for data analysis. In total, 300 completed questionnaires were received and the mean age of respondents was 29.89 ± 11.17 years (range: 20-75 years). Among the study population, 284 (94.67%) perceived the threat of infection highly. Washing hands frequently with water and soap and use of hand sanitizer was reported by 93.33%, of participants. Age (P = 0.010), sex (P = 0.002) and occupation field (P = 0.010) were significantly associated with danger control responses. Data identified that those oral health care providers that were on the danger control response adopted preventive behaviors more strictly than those on fear control response. The results of this study showed how degrees of perceived threat and perceived efficacy influenced oral health providers' willingness to perform recommended health behaviors. These findings can assist public health agencies in developing educational programs specifically designed for promoting preventive behaviors among oral health providers in pandemic situations.

Transgender youth and oral health: a qualitative study

Transgender youth face several comorbidities with oral health implications, including depression, harmful eating behaviors, and pharmaceutical side-effects. No information exists on how transgender youth view oral health or how they interface with oral health providers. The purpose of this study was to elicit experiences, knowledge, and perceptions of oral health among transgender youth and their caregivers. This was a qualitative study using in-person and telephone interviews with English-speaking transgender youth (12–24 years old), with and without their caregivers. Interviews were conducted using a semi-structured interview guide and transcribed verbatim. Statements from interviews were coded by theme. Recruitment ended when thematic saturation was reached, determined by investigators. 16 patients and 16 caregivers completed interviews. Overall, participants indicated no connection between transitioning and oral health. Many reported abandoning self-care, including oral health practices. Patients and caregivers alike did not prioritize disclosing transition-related information with oral health providers, despite uncertainty on the effects of related treatments on the oral cavity. At a time when transitioning youth may be in contact with health care providers more frequently and may be more inclined to share transition related details with them, the healthcare provider is uniquely positioned to encourage improved oral health emphasis and outcomes.

Parents’ receptiveness to oral health clinic-based vaccination

In the United States, utilization of the human papillomavirus (HPV) vaccine has lagged far below public health goals for achieving satisfactory population-level protection against HPV associated cancers. Oral health professionals such as dentists and dental hygienists are important stakeholders in primary prevention of HPV-associated oropharyngeal cancer. We surveyed parents accompanying children to a local pediatric oral health clinic to ascertain their receptiveness to engaging their child’s oral health team in their child’s immunizations. Parents were generally receptive (86%) to discussing vaccines available for their children with both their child’s dentist and dental hygienist. The majority of parents (79%) reported that they would allow their child’s dentist to administer a vaccine to their child. Oral health providers are trusted healthcare professionals poised to make a positive impact on adolescent vaccination programs and they should be included in efforts to improve HPV vaccination rates.

Oral Sex Knowledge and Experience of Transgender Youth: An Opportunity for Dental Education.

Recent evidence suggests that, when compared to their cisgender counterparts, transgender youth exhibit more unsafe sexual behavior that may elevate their risk for sexually transmitted infections. The aim of this study was to better understand what transgender youth know about oral sex, related consequences, and mechanisms of protection and where they obtained this information. The findings can be helpful in preparing oral health providers to play a role in meeting this public health need. The study took place at a U.S. academic pediatric medical center in 2017. Participants were recruited at a Transgender Research Day and during Transgender Clinic sessions. English-speaking transgender adolescents ages 14 to 24 were invited to participate in a previously validated survey about their knowledge and behaviors related to oral sex. Of the 138 transgender youth invited to participate, 57 completed the surveys, for a 41% response rate. Most respondents reported feeling they understood the necessity of protection and consequences of oral sex but did not use protection. Over half of the participants (58%) said they had not had a physician, dentist, or parent speak to them about oral sex. Given the lack of standardized, evidence-based sex education, it is imperative that adolescents, particularly in highly vulnerable populations like transgender youth, receive accurate information about oral sexual contact. Dental schools should prepare future practitioners to address these issues with youth using a culturally competent, evidence-based approach.

Mammalian Target of Rapamycin (mTOR) Inhibitors Induce Stomatitis in Patients with Metastatic Breast Cancer (Review)

Metastatic breast cancer patients may acquire oral morbidity from therapeutic procedures. A common adverse event (AE) of the Mammalian target of rapamycin (mTOR) inhibitor is associated stomatitis (mIAS) secondary to mTOR inhibitor therapy, which have a negative impact on the quality of life, therapy adherence and health care expenses. A multidisciplinary team strategy is essential for reducing mIAS and capitalize on therapy advantages for breast cancer patients. We discuss the pathophysiology, diagnosis, and natural history of mIAS in this review. In the context of promoting a coordinated team care approach to optimizing patient care, current and new management policies are outlined for the prevention and treatment of mIAS. Types of Studies Reviewed: We piloted different research from 2007 through 2019 using the terms “stomatitis,” “mIAS,” “mTOR,” “everolimus,” “oral care.” and “metastatic breast cancer,” We have chosen papers from peer-reviewed journals reporting controlled trials and evidence-based guidance. Results: Cytototoxic chemical or radiation therapy causes, clinical presentation, and paradigms of therapy can distinguish mIAS from mucositis. The continuum of patient oral health care may include specific preventive and therapeutic leadership approaches. Practical consequences: Oral health providers are at the forefront of oral health care for patients who have metastatic breast cancer and are uniquely positioned to deliver patient education, to advocate precise reporting of mIAS, and to encourage early identification, monitoring and rapid intervention to reduce the serious and time-limiting dose of this manageable AE.