Incidence of oral complications and application of a preventive protocol in children with acute leukemia

Authors

  • Mariana P. Levy-Polack DDS,

    Corresponding author
    1. Dr. Levy-Polack is Assistant Clinical Professor, Pediatric Dentistry Department, University of Maryland Dental School, Baltimore, Maryland.
      should be addressed to Dr. Levy-Polack at 4222 Pinefield Ct., Randallstown, MD 21133.
    Search for more papers by this author
  • Patricia Sebelli DDS,

    1. Dr. Sebelli is Associate Professor, Pediatric Dentistry Department, University of Buenos Aires, Argentina.
    Search for more papers by this author
  • Noemi L. Polack DDS

    1. Dr. Polack is Associate Professor, Pediatric Dentistry Department, University of Buenos Aires, Argentina.
    Search for more papers by this author

should be addressed to Dr. Levy-Polack at 4222 Pinefield Ct., Randallstown, MD 21133.

Abstract

This prospective, controlled study was designed to assess the effectiveness of a preventive oral protocol in children receiving antineoplastic treatment for acute lymphoblastic leukemia (ALL). During a 13-month period, 96 children from one to 16 years of age with a diagnosis of ALL were evaluated. When the study was initiated, 60 patients already undergoing chemotherapy received palliative treatment for complications (Group I). Thirty-six children (Group II) with newly diagnosed ALL received a daily preventive protocol consisting of: (1) elimination of bacterial plaque; (2) application of a mouthwash with a non-alcoholic solution of chlorhexidine 0.12% and (3) topical application of lodopovidone, followed by “swish and swallow” with nystatin 500,000 units. Children in both groups were examined every 7 to 14 days by our pediatric dentistry team. We found a significant improvement in oral hygiene (p = 0.001) and a significant decrease in the incidence of mucositis grade 2 (p = 0.0013) and oral candidiasis (p = 0.009) in the Group II children. These findings show that the systematic application of a preventive protocol significantly reduces the incidence of oral complications. The results of this study identify a need to include a pediatric dentist in a multidisciplinary team which provides oral care for cancer patients.

Ancillary