Dentist and PhD student Juliette Stolze, who works two days a week at the Máxima and ACTA in Amsterdam, says: ‘Good preventive information, education and advice for both children and parents is an important part of the oral care guideline. During the treatment of childhood cancer, good oral hygiene is extremely important because although it cannot completely prevent the development of mucositis (painful sores in the mouth), it can reduce its severity and duration. Good oral hygiene also reduces the risk of infections and cavities (caries).’
Preventive screening
Juliette: ‘It is important that every child is seen by the dentist during the first admission and prior to treatment. The teeth are then cleaned before the oncological treatment starts. During chemotherapy, a clean, healthy mouth is important to prevent infections from the mouth due to low immunity and damaged oral mucosa. In addition, it can be prevented that teeth or molars still have to be extracted in a phase when platelets and granulocytes are low. Bleeding may then occur and there is a higher risk of infection and chance of poor wound healing. Furthermore, it is important that factors that can damage the oral mucosa, such as braces, are removed. For radiation treatment in the head and neck area, preventive screening is also aimed at long-term problems, such as radiation caries.’
Dry mouth
After treatment for childhood cancer, lasting effects may occur in the mouth. Juliette Stolze investigated the prevalence (how often does it occur) and risk factors of dry mouth, dental problems, subjective oral health and oral health-related quality of life. The PhD candidate says: ‘Our results on oral health in 249 childhood cancer survivors are significant. Dry mouth is common, especially in survivors who received radiation to the head and neck area (45.9%), and this has adverse consequences for oral health. Abnormalities in dental development occur in one in three survivors. Risk factors include a younger age at diagnosis (<3 years) and therapy with a specific group of cytostatics (alkylating agents). Despite these complications, we saw that oral health and the quality of life experienced is relatively good. Survivors may not be used to anything other than having a dry mouth, so they won't notice it. However, the oral problems do deserve attention. If survivors have too little saliva, the risk of caries and fungal infections is increased. And abnormalities in dental development, such as missing teeth or tooth roots that are too short, can also cause problems.'
Better follow-up care
Juliette Stolze: ‘The conclusion of my dissertation is that oral complications as a result of cancer therapy occur frequently among survivors at a young age. Awareness in this area is therefore important, among oral care professionals, pediatric oncologists, nurses and survivors themselves. Regular visits to the dentist should definitely be part of follow-up care, so that oral problems can be prevented where possible or identified at an early stage. Also in the long term. That is why the nurses, led by Ida Ophorst, are continuing to work on the implementation of the new oral care guideline in Máxima. Paying attention to the mouth in the initial phase will also pay off in the long term, and that is very important when you read my research results.’
Promotion Juliette Stolze
‘Oral health in cancer survivors. Especially in those treated during childhood’
September 19, 4:00 PM
Agnietenkapel, Amsterdam
Supervisors: Dr. Henk Brand, co-supervisors: Dr. Dorine Bresters, Dr. Judith Raber-Durlacher
https://doi.org/10.3390/cancers14143379
Stolze J, Teepen JC, Raber-Durlacher JE, Loonen JJ, Kok JL, Tissing WJE, et al (2022). Prevalence and Risk Factors for Hyposalivation and Xerostomia in Childhood Cancer Survivors Following Different Treatment Modalities—A Dutch Childhood Cancer Survivor Study Late Effects 2 Clinical Study (DCCSS LATER 2). Cancers 14, 3379. https:// doi.org/10.3390/cancers14143379
2023-09-12 18:20:00
#Late #effects #childhood #cancer #therapy #oral #health #Healthcare
