Title: A literature review on the oral and dental manifestations in paediatric oncology patients using PRISMA guidelines
Abstract:
Background and Aims: There are 1,878 new cancer diagnoses in children in United Kingdom. Oral infection or disease can be a serious contraindication to progression of further surgical treatment and quality of life.
The aim of this review is to evaluate current research in oral health complications associated within the paediatric oncology patient population. The secondary aim is to raise awareness of the need for dental care in this vulnerable cohort and highlight oral complications and treatment modalities available.
Methodology: PubMed literature review with use of PRISMA guidelines. Search terms: paediatric oncology and dentistry and oral or dental. 1,511,086 results found. Articles filtered for randomised controlled trials, metanalysis, systematic review, reviews and clinical trials (N=104,374). Articles filtered by age range and human species (N=15,353). Articles filtered for English language (N=14,767). Articles screened for full text (N=5,793). Articles screened by title (N=21). Articles screened by abstract (N=17). Inclusion criteria limited to patients aged 18 and under.
Results: Critical appraisal of all included literature was completed, examining hierarchy of evidence, patient contact, author, type of study. In total, there were 4 randomised controlled trials, 7 reviews, 4 studies and 2 systematic reviews. Dental implications ranged from oral mucositis, candidiasis and gingivitis. Agenesis was seen most in children undergoing chemotherapy. Significant oral implications associated with haemopoietic stem cell transplants. Lymphocytic leukaemia is mostly associated with paediatric patients and oral implications. Treatment modalities examining cryotherapy and lasers for mucositis have been recommended.
Conclusion: The oral implications associated with cancer diagnosis, treatment and therapy are significant. It is imperative to manage each paediatric patient as holistically as possible. Members of oncology team should recognise oral health complications and implement appropriate management, symptomatic relief or referral to specialist. Further research into reporting of oral manifestations and possible interventions are needed to establish a standardised oral health care model for paediatric oncology patients.
