Ritwik Priyanshi
Department of Pediatric Dentistry, Louisiana State University Health Sciences Center School of Dentistry, New Orleans, LA.
Ochsner J. 2018 Winter;18(4):351-357. doi: 10.31486/toj.18.0061.
Childhood cancer is the second most common cause of death in children in the United States. Treatments for childhood cancers usually incorporate chemotherapy, radiation therapy, immunotherapy, and/or surgery. This review of contemporary literature highlights the necessity for interprofessional care to achieve the best dental outcomes for this patient population during cancer treatment, as well as for children who are long-term cancer survivors.
A literature search at PubMed identified research and review articles about oral and dental complications in children diagnosed with cancer. Also included were evidence and current best practices from guidelines published by the American Academy of Pediatric Dentistry on dental management of pediatric patients receiving chemotherapy, hematopoietic cell transplantation, and/or radiation therapy. Finally, clinical recommendations from the European Society for Medical Oncology Guidelines Working Group on management of oral and gastrointestinal mucositis were included. The literature search was limited to articles published in the English language.
Children with a new diagnosis of cancer should have dental care provided by a pediatric dentist to mitigate the oral complications from cancer treatment as well as to avoid dental infections during immunosuppressed states. An individualized oral care program can be developed for each patient to manage and treat acute and long-term oral complications related to cancer treatment.
Childhood cancer survivors present with unique challenges for dental management because of dental anomalies caused by cancer therapy. Interprofessional collaborative care between the pediatric dentist and the oncologist during and after cancer therapy will enable best outcomes for the pediatric patient. In addition, dental professionals must be prepared to meet the unique needs of long-term cancer survivors because of the increasing survival rates of childhood cancers.
儿童癌症是美国儿童死亡的第二大常见原因。儿童癌症的治疗通常包括化疗、放疗、免疫疗法和/或手术。这篇当代文献综述强调了跨专业护理的必要性,以便在癌症治疗期间为该患者群体以及长期癌症幸存者实现最佳的口腔治疗效果。
在PubMed上进行文献检索,确定了关于诊断为癌症的儿童口腔和牙齿并发症的研究及综述文章。还纳入了美国儿科学会发布的关于接受化疗、造血细胞移植和/或放疗的儿科患者牙齿管理的指南中的证据和当前最佳实践。最后,纳入了欧洲医学肿瘤学会指南工作组关于口腔和胃肠道黏膜炎管理的临床建议。文献检索仅限于以英文发表的文章。
新诊断为癌症的儿童应由儿科牙医提供牙齿护理,以减轻癌症治疗引起的口腔并发症,并避免在免疫抑制状态下发生牙齿感染。可以为每位患者制定个性化的口腔护理计划,以管理和治疗与癌症治疗相关的急性和长期口腔并发症。
由于癌症治疗导致的牙齿异常,儿童癌症幸存者在牙齿管理方面面临独特的挑战。在癌症治疗期间及之后,儿科牙医和肿瘤学家之间的跨专业协作护理将为儿科患者带来最佳治疗效果。此外,由于儿童癌症存活率的提高,牙科专业人员必须准备好满足长期癌症幸存者的独特需求。