Carcinomas have an extremely negative impact on the quality of life of pediatric patients and require an individualized oral approach to the treatment of all stages of the disease, announced the Institute for Public Health (IJZ).
On the occasion of the International Day of Children with Malignant Diseases, the IJZ said that the prognosis of cancer in children has improved significantly in recent years, reaching the world's five-year survival rate of 84 percent in children under the age of 14.
"The most common types of cancer in children globally are leukemia, 25-35 percent, acute lymphoblastic leukemia 78 percent and acute myeloblastic leukemia 16 percent, tumors of the central nervous system 22,6 percent, lymphomas 15,6 percent and neuroblastomas or tumors of the sympathetic nervous system 7,8 percent," the statement said.
IJZ said that proper oral care for children with leukemia is very important.
As they said, understanding the nature of the disease and its treatment is an important part of overall patient care.
The IJZ pointed out that the goal of dental care before treatment is to prevent oral complications during chemotherapy.
Hospital dental care, they stated, includes treatment of oral infections and relief of acute oral symptoms that may complicate cancer therapy.
"Dental care during remission should focus on maintaining the health of the affected child's teeth," says the announcement.
The IJZ said that the initial signs and symptoms of leukemia can appear in the mouth or neck due to the penetration of leukemic cells, or the associated reduction of normal elements in the bone marrow.
As they said, the cancer/leukemia patient faces oral health problems both because of the disease and the treatment options.
The IJZ clarified that oral complications are mostly related to pre-existing factors - caries, gingivitis and poor hygiene, which affect their initiation, increase and persistence.
They stated that one of the treatment options for leukemia is chemotherapy, which can lead to side effects such as nausea and/or vomiting, diarrhea, fatigue, alopecia, neuropathy, opportunistic infections, and oral mucositis.
The IJZ said that systemic consequences as a result of those drugs or radiation can cause a series of oral and dental complications.
"Direct and indirect harmful effects on the oral cavity are associated with the development of ulcerative, hemorrhagic or infectious complications - gingival bleeding, ulcerations, mucositis, change in taste, desquamation of the skin, xerostomia, opportunistic infections," the announcement states.
The IJZ said that as a result, all these problems can increase the risk of complications of the underlying disease.
They said that a proper understanding of the pathogenesis of oral complications in these patients is important for oncologists and hematologists who treat children, and a multidisciplinary approach is necessary to improve the quality of life of patients.
As stated by the IJZ, since the occurrence of oral complications is related to several factors, the treatment of these conditions requires a multidisciplinary team that includes an oncologist, a hematologist, a dentist and an intensive care specialist.
They said that, ideally, all dental interventions should be completed before starting cancer therapy.
"If this is not feasible, the priority treatments are the removal of acute sources of infection, such as extraction of teeth with complicated caries, periodontal disease, root canal therapy of permanent teeth and replacement of defective restorations, in order to avoid irritation of the oral tissue," the statement says.
The IJZ stated that the oral mucosa is very sensitive to the effects of chemotherapy and radiotherapy due to high mitotic activity and that it is the most common documented source of sepsis in immunosuppressed pediatric patients with leukemia.
For these reasons, as they said, early and definitive dental intervention, including comprehensive measures of oral hygiene, reduce the risk of oral and related systemic complications.
The IJZ said that careful oral care is important for reducing the frequency and severity of oral consequences of the treatment protocol.
They said that parents and children should be educated about the importance of good oral hygiene practices throughout oncology treatment, regardless of the child's hematological status.
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