Bendoraitiene Egle Aida, Andruskeviciene Vilija, Kscenaviciute Gabriele, Srebaliene Evelina, Maciulaityte Ieva
Department of Preventive and Paediatric Dentistry, Lithuanian University of Health Sciences, KaunasLithuania.
Private practice.
J Oral Maxillofac Res. 2020 Nov 30;11(3):e5. doi: 10.5037/jomr.2020.11305. eCollection 2020 Jul-Sep.
According to the National Cancer Institute of Lithuania, cancer is diagnosed for almost 100 children each year. Oncological patients suffer from complications during and after treatment. Radiation therapy also affects dental hard tissues. Many oncological patients lose motivation to take care of their oral hygiene because they are focused on cancer diagnosis. This case report discusses prevention and dental treatment severity after radiation therapy treatment.
A 9-year-old boy with cancer diagnosis visited a dentist in 2017. The patient was complaining about poor aesthetic quality of the teeth, but there were no complaints about teeth sensitivity or pain. Different stages of active caries, poor oral hygiene, visible abundant plaque, swollen, red and bleeding gums were observed during appointment. A motivational interview explaining the importance of oral hygiene was conducted. Non-surgical caries treatment was prescribed during the first visit. Restorative treatment was performed after 1 month.
The motivational interview explaining the importance of oral hygiene was conducted during every appointment per 3-year period. Unfortunately, oral hygiene is still poor due to the lack of motivation. Active-cavitated caries lesions were restored with glass ionomer cement and composite resin. The aesthetics of teeth was improved.
Oncological and recovered patients after radiation therapy should be assigned to a high risk of caries. These patients should be treated individually by the algorithm. Psychological or psychotherapeutic assistance is necessary for patients due to motivation for treatment and oral care.
根据立陶宛国家癌症研究所的数据，每年有近100名儿童被诊断出患有癌症。肿瘤患者在治疗期间和治疗后会出现并发症。放射治疗也会影响牙齿硬组织。许多肿瘤患者因为专注于癌症诊断而失去了保持口腔卫生的动力。本病例报告讨论了放射治疗后的预防措施和牙科治疗的严重程度。
一名9岁的癌症患儿于2017年就诊于一名牙医。患者抱怨牙齿美观质量差，但没有牙齿敏感或疼痛的症状。就诊时观察到活跃龋的不同阶段、口腔卫生差、可见大量菌斑、牙龈肿胀、发红和出血。进行了一次动机访谈，解释了口腔卫生的重要性。首次就诊时开了非手术龋治疗的处方。1个月后进行了修复治疗。
在每3年的每个就诊期间都进行了一次动机访谈，解释口腔卫生的重要性。不幸的是，由于缺乏动力，口腔卫生仍然很差。用玻璃离子粘固剂和复合树脂修复了活跃龋损。牙齿的美观得到了改善。
放射治疗后的肿瘤患者和康复患者应被归类为高龋风险人群。这些患者应按照算法进行个体化治疗。由于治疗和口腔护理的动机，患者需要心理或心理治疗方面的帮助。
