Search Results (9)

Oncological patients or the individuals scheduled for cardiovascular surgeries are at risk of both oral and systemic complications when existing dental pathologies are not addressed before these therapies. This narrative review explores the current literature on the role of pre-treatment dental care in reducing unfavorable outcomes and promoting treatment efficacy in medically compromised patients. The data show that early dental intervention, particularly prior to head and neck radiotherapy, considerably reduces the risk of osteoradionecrosis, rampant radiation caries, and xerostomia. Chemotherapy-associated mucositis, infections, and microbial imbalance are similarly worsened by untreated oral disease but may be managed through early sanitation and hygiene reinforcement. In cardiac patients, conditions such as apical periodontitis and periodontitis may lead to bacteremia, infective endocarditis, or prosthetic valve infections, highlighting the systemic relevance of oral health. Tooth extractions, restorative treatment of carious lesions, and control of active oral infections performed before systemic therapy can reduce complication rates, improve treatment continuity, and enhance patients’ quality of life. Integrating comprehensive dental assessment into routine pre-treatment planning allows early identification of oral health risks and supports a multidisciplinary approach that optimizes overall clinical outcomes. Full article

Background/Objectives: Cancer patients undergoing chemotherapy (CT) or radiotherapy (RT) are at increased risk of oral complications. Preventive dental care has been proposed to mitigate these risks, yet its effectiveness is not sufficiently evaluated. This systematic review and meta-analysis aimed to assess the impact of preventive oral health interventions on key clinical outcomes in oncology patients. Methods: A systematic search of MEDLINE, Embase, and CENTRAL databases was conducted (March 2025), adhering to PRISMA guidelines with a PROSPERO-registered protocol (CRD 420251006799). Eligible studies included randomized trials, cohort studies, and pre–post intervention studies evaluating preventive dental care in patients receiving CT or RT. The outcomes included gingival index (GI), dental caries (DMFT), plaque levels, and periodontal health. Meta-analyses were performed on GI and DMFT outcomes using random-effects models. Results: Eleven studies were included in the qualitative synthesis and four in the meta-analyses. Preventive interventions, such as fluoride applications, oral hygiene education, and regular professional cleanings, were associated with stabilization or improvement of gingival health. The pooled estimate for GI showed no significant deterioration over time (MD = −0.05, 95% CI: −0.34 to 0.24, p = 0.72). For DMFT, a slight but significant increase was observed (MD = 1.07, 95% CI: 0.08 to 2.05, p = 0.03), suggesting a continued risk of caries despite intervention. Conclusions: Preventive dental care interventions appear to support the maintenance of gingival health in cancer patients undergoing CT or RT. However, despite these interventions, a slight increase in dental caries was still observed, indicating that preventive strategies may not fully eliminate the risk of caries. These findings highlight the importance of sustained and individualized oral health programs as part of comprehensive oncology care. Future studies using standardized protocols and longer follow-up periods are needed to better evaluate their long-term effectiveness across diverse cancer populations. Full article

Introduction: Generally, after an oral oncological therapeutic process in which, unfortunately, surgery plays a fundamental role, a reconstructive and rehabilitative procedure should be initiated, seeking as far as possible to recover the patient’s vital functions (mastication, aesthetics, and phonetics). Case report: We present the case of a patient who successfully underwent treatment for mandibular sarcoma. After a disease-free period of one year, following oncological treatment, an intervention was performed for the insertion of dental implants into the fibula to subsequently rehabilitate the patient prosthetically. There were several challenges, including free-end edentulous space in the lower jaw with a depth of 18 mm on peri-implant tissues consisting of osteoseptocutaneous skin graft, hypotonic perioral musculature, and high aesthetic expectations of the patient. An overdenture with a titanium milled bar substructure with retentive prosthetic components was chosen for treatment. This implant-supported removable prosthesis was selected to facilitate cleaning, since the patient did not maintain oral hygiene habits. The patient was educated on using and handling the prosthesis, and the treatment objectives were achieved (to restore aesthetics and masticatory function). Conclusions: Removable prostheses are a valid alternative for oncologic patients and patients with unfavorable conditions for more complex implant-supported rehabilitation. Full article

Introduction: Head and neck squamous cell carcinoma (HNSCC) ranks sixth among cancers in the world, and the 5-year survival rate ranges from 25% to 60%. The risk factors for HNSCC are primarily smoking, alcohol consumption and human papillomavirus (HPV). Data indicate that 15–20% of cancers are caused by infectious agents, 20–30% by smoking and 30–35% by unhealthy lifestyles, diet, lack of physical activity and obesity. Dysbiosis is a microbiome imbalance, which promotes oncogenesis by intensifying inflammatory processes and affecting the host’s metabolism. Profiling the microbiome in various types of cancer is currently the subject of research and analysis. However, there is still little information on the correlation of the microbiome with HNSCC and its impact on oncogenesis, the course of the disease and its treatment. Objective: The aim of the study was to prospectively assess risk factors with assessment of the impact of the microbiome on the risk of squamous cell carcinoma of the larynx. The study included a group of 44 patients diagnosed with squamous cell carcinoma of the larynx and 30 patients from the control group. Results: In the control group, bacteria of the normal microbiome dominated—the genus Streptococcus, Gemella, Neisseria and Kingella. In the group of patients with laryngeal cancer, Prevotella, Clostridiales and Stomatobaculum were found significantly more often. Porphyromonas, Fusobacterium, Lactobacillus, Actinobacteria, Actinomyces and Shaalia odontolytica were also found at a higher percentage in the study group. Analyzing the phylum, Firmicutes dominated in the control group; there were statistically significantly more of them than in patients from the study group. Bacteroides and Bacillota were found significantly more often in patients with laryngeal cancer. Conclusions: The importance of the microbiome in oncology has been confirmed in many studies. Independent risk factors for laryngeal cancer were primarily a lower number of Firmicutes in the microbiome, but also an increased leukocyte level above 6.52 × 10³/mm and a decreased total protein level below 6.9 g/dL. Prevotella, Clostridiales, Stomatobaculum, Porphyromonas, Fusobacterium, Lactobacillus, Actinobacteria, Actinomyces and Shaalia were considered to be the bacteria contributing to the development of laryngeal cancer. Streptococcus, Gemella, Neisserie and Kingella were considered to be protective bacteria. Moreover, the study confirmed the significant impact of smoking, alcohol consumption and poor oral hygiene on the development of laryngeal cancer. The microbiome, its identification and manipulation may constitute a breakthrough discovery for improving the diagnosis and oncological therapy of laryngeal cancer, and also of the entire group of HNSCC. Profiling the microbiome may allow for personalized therapy related to its modification. Assessing the microbiome of patients diagnosed with cancer may provide an opportunity to predict treatment response and effectiveness. Full article

This review aims to provide a comprehensive overview of the literature on the oral side effects caused by radiotherapy for head and neck cancers. Various treatments are examined to mitigate these sequelae, and a protocol is proposed for dentists and dental hygienists to manage oncological patients. A literature search was conducted to select relevant articles addressing the effects of radiotherapy treatments on the oral cavity, with a particular focus on the development of mucositis, candidiasis, changes in salivary pH, trismus, fibrosis, and alterations in the oral biofilm. PubMed and MedLine were used as search engines, with keyword combinations including: head and neck cancer, mucositis, candida, dental care, dental hygiene, epidemiology, oral microbiome, biofilm, trismus, fibrosis, and salivary pH. A total of 226 articles were identified, spanning the period from 1998 to 2023. Articles deemed inappropriate or in languages other than English or Italian were excluded. A management protocol for oncological patients was proposed, divided into two phases: home-based and professional. Despite the advancements in intensity-modulated radiation therapy, it is impossible to completely avoid damage to healthy tissues. Preventive education and counseling in the dental chair, ongoing motivation, and education about oral hygiene are crucial to combine a good therapeutic outcome with an improved quality of life for the patient. Full article

Infections pose a significant threat to morbidity and mortality during treatments for pediatric cancer patients. Efforts to minimize the risk of infection necessitate preventive measures encompassing both environmental and host-focused strategies. While a substantial number of infections in oncologic patients originate from microorganisms within their native microbiological environment, such as the oral cavity, intestines, and skin, the concrete risk of bloodstream infections linked to the consumption of contaminated food and beverages in the community cannot be overlooked. Ensuring food quality and hygiene is essential to mitigating the impact of foodborne illnesses on vulnerable patients. The neutropenic diet (ND) has been proposed to minimize the risk of sepsis during neutropenic periods. The ND aims to minimize bacterial entry into the gut and bacterial translocation. However, a standardized definition for ND and consensus guidelines for specific food exclusions are lacking. Most centers adopt ND during neutropenic phases, but challenges in achieving caloric intake are common. The ND has not demonstrated any associated benefits and does not ensure improved overall survival. Consequently, providing unified and standardized food safety instructions is imperative for pediatric patients undergoing hematopoietic cell transplantation (HCT). Despite the lack of evidence, ND is still widely administered to both pediatric and adult patients as a precautionary measure. This narrative review focuses on the impact of foodborne infections in pediatric cancer patients and the role of the ND in comparison to food safety practices in patients undergoing chemotherapy or HCT. Prioritizing education regarding proper food storage, preparation, and cooking techniques proves more advantageous than merely focusing on dietary limitations. The absence of standardized guidelines underscores the necessity for further research in this field. Full article

Background: In the literature, among oral health prevention programs dedicated to cancer patients, a wide heterogeneity is evident. The purpose of this work is to analyze the available scientific evidence for the treatment of head and neck cancer (HNC) patients undergoing resective surgery and radiotherapy and to draw up a diversified oral hygiene protocol during oncological therapy. Methods: PubMed was used as database. Studies published from 2017 to September 2022 were analyzed. Studies investigating the effectiveness of the preventive procedures carried out by the dental professionals in HNC patients undergoing postoperative adjuvant therapy have been taken into account. Results: The application of the search string on PubMed allowed the selection of 7184 articles. The systematic selection of articles led to the inclusion of 26 articles in this review, including 22 RCTs, 3 observational studies, and 1 controlled clinical study. Articles were divided according to the debated topic: the management of radiation-induced mucositis, xerostomia, the efficacy of an oral infection prevention protocol, and the prevention of radiation-induced caries. Conclusions: Dental hygienists are fundamental figures in the management of patients undergoing oncological surgery of the maxillofacial district. They help the patient prevent and manage the sequelae of oncological therapy, obtaining a clear improvement in the quality of life. Full article

Cancers have a highly negative impact on the quality of life of paediatric patients and require an individualised oral treatment program for the phases of the disease. The aim of this study was to update existing research on oral care in children diagnosed with cancer. We carried out a literature search (in English, Spanish and Portuguese) in the Pubmed, Cochrane Library, EBSCO, WOS, SciELO, Lilacs, ProQuest, and SCOPUS databases and the websites of hospitals that treat childhood cancers. We found 114 articles and two hospital protocols. After review, we describe the interventions necessary to maintain oral health in children with cancer, divided into: phase I, before initiation of cancer treatment (review of medical record and oral history, planning of preventive strategies and dental treatments); phase II, from initiation of chemo-radiotherapy to 30–45 days post-therapy (maintenance of oral hygiene, reinforcement of parent/patient education in oral care, prevention and treatment of complications derived from cancer treatment); phase III, from 1 year to lifetime (periodic check-ups, maintenance, and reinforcement of oral hygiene, dental treatments, symptomatic care of the effects of long-term cancer treatment). The use of standardised protocols can avoid or minimise oral cancer complications and the side effects of cancer therapies. Full article

Background: In recent years, the incidence of neoplastic diseases in children has increased significantly. Immunodepression triggers undesirable effects in the oral cavity such as mucositis, opportunistic infections, oral bleeding, xerostomia, dysgeusia, decay, dental malformations and pain. Objective: We aim to assess, through salivary tests, the quality of saliva in pediatric patients affected by oncohematological diseases and treated with chemo/radiotherapy compared to non-treated subjects. Methods: A total of 20 subjects aged between 5 and 18 years, with oncological pathologies undergoing radio and/or chemotherapy, were evaluated. The control group consisted of 20 healthy children of the same age. The two groups of subjects were asked to undergo salivary tests. Descriptive statistics were computed for each item. Fisher’s exact test was conducted to compare case and control groups. Results: Subjects treated with chemo/radiotherapy had a lower pH and therefore a higher salivary acidity that predisposes to caries and the oral hygiene of children with oncohematological diseases was more deficient than that of the control group. Conclusions: The early detection of these indicators, and the prevention carried out to limit their severity, is an important aspect of the comprehensive care of oncohematological subjects. Pediatric dentists can play a crucial a role enabling good quality of life during cancer therapy. Full article