FEATURES OF RENDERING DENTAL CARE TO PATIENTS WITH MALIGNANCIES DURING CHEMOTHERAPY

Filon A. M., Vozniy O. V., Kolesnik O. P.

LITERATURE REVIEWS

Scentific article

Today in Ukraine, 800,000 people have oncologic diseases. According to the forecast by 2020, the number of those who first felt ill with cancer could reach 200,000 per year, and the total number of cancer patients will significantly exceed one million people. In Zaporozhe region 2012-2014, for every 100 thousand people, about 450 cases of manifestation of oncological diseases were registered annually. Сhemotherapy is rapidly changing on the basis of protocols of evolution and quality improvement, and the introduction of new therapeutic approaches. Dental treatment before, during and after anticancer chemotherapy requires specialist knowledge. The purpose of a dental examination before chemotherapy is to determine an existing or potential infection of the oral cavity. Control of infection of the oral cavity should be prescribed before the start of chemotherapy, because preventing complications is much easier than then to deal with its consequences. Object and methods. In this article, we decided to highlight the most common dental complications that were the purpose of our study. There was a comprehensive search of the PubMed-Medline, Cochrane Library and Scopus databases that crossed the key words «oral mucositis», «prevention» and «treatment» with the terms «oncology» «chemotherapy» and «radiation therapy», «xerostomia», «dysgeusia» 368 articles were received, of which 136 corresponded to the inclusion criteria. Results. Major complications in the oral cavity and side effects of chemotherapy are associated with such conditions as existing intrauterine pathology, depolymerized teeth, severe periodontal diseases and inflammations of the mucosa caused by chemotherapy. Indeed, mouth infection with dental caries, intraosseous pathology, such as cysts or pronounced periodontal diseases can lead to the development of life-threatening infections and feverish conditions in chemotherapy-dependent patients. Such infections may create the need to interrupt chemotherapeutic treatment, and therefore, it can make a compromise outcome of the treatment of a cancerous tumor. Inflammation of the mucosa associated with chemotherapy leads to partial rejection of the epithelium of the oral cavity, resulting in mild infections of the open wounds of the mucosa may be a bacterial, viral or fungal infection. A dental examination before chemotherapy is an important factor in detecting existing or potential oral cavity infections. The control of infection of the oral cavity must be performed before chemotherapy begins. During chemotherapy, patients are often immune-deficient, so dental infection or treatment can have serious consequences. The dentist should use an atraumatic technique. Surgical dentistry should be completed before the start of chemotherapy, with the priority of temporary or permanent restoration of major carious lesions. Tooth extractions must be completed before chemotherapy appointment. Based on the patient’s blood clotting status, the oncologist can determine how soon chemotherapy can begin after the withdrawals. Patients who have already started chemotherapy and absolutely necessary removal are shown careful tissue management, suitable for suturing and control of local bleeding. Chemotherapy is usually delayed until the dentist and oncologist have determined whether the patient’s blood clotting status is satisfactory. The healing of the extraction area is monitored by the dentist for at least 3 days after surgery. Сonclusions. Dental care for patients with malignant neoplasms is a very topical and important aspect in the complex treatment of cancer patients. This article highlights the relationship between dentistry and oncology. There should be a multidisciplinary approach, the interaction of the dentist and oncologist in the prevention and treatment of dental complications of chemotherapy.

oral mucositis, prophylaxis and prevention with the terms «oncology», «chemotherapy», xerostomia, dysgesia.

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«Bulletin of problems biology and medicine» Issue 4 Part 2 (154), 2019 year, 52-56 pages, index UDK 616.31-06:616-006.6-085.277.3]-08

10.29254/2077-4214-2019-4-2-154-52-56