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Diş Hekimlerinin Pediatrik Onkoloji Hastalarındaki Dental Tedavilere Yaklaşımları

Yıl 2020, Ağız Kanserleri Özel Sayısı, 50 - 57, 28.09.2020
https://doi.org/10.20515/otd.769424

Öz

Günümüzde onkoloji tedavisi gören hastaların büyük bir çoğunluğunu pediatrik yaş grubundaki hastalar oluşturmaktadır. Onkoloji tedavisi sırasında görülebilecek olası komplikasyonların önlenmesi, tedavisi ve oral sağlığın idamesinde dişhekimlerinin rolü büyüktür. Bu çalışmada, dişhekimlerinin pediatrik onkoloji hastalarındaki dental tedavilere yaklaşımlarının değerlendirilmesi amaçlanmıştır. Çalışma için demografik bilgileri ve pediatrik onkoloji hastalarındaki dental tedavi yaklaşımlarını içeren 20 soruluk bir anket hazırlanmıştır. Çalışmaya, 112 dişhekimi (74 kadın, 38 erkek) dahil edilmiştir. SPSS Version23 istatistik yazılım programı aracılığıyla tanımlayıcı istatistikler ve ki-kare testi yapılmıştır. Onkolojik tedavi öncesi dişhekimlerinin %69,6’sı semptomatik daimi dişlere, %37,5’i asemptomatik daimi dişlere, % 33’ü semptomatik süt dişlerine endodontik tedavi uygulanması gerektiğini ifade etmiştir. Dişhekimlerinin %69.6’sı onkolojik tedavi öncesi tüm mobil süt dişlerinin çekilmesi gerektiğini belirtmiştir. Tüm dişhekimlerinin %43,8’i meslek hayatı boyunca en az bir pediatrik onkoloji hastası muayene etmiş, bu dişhekimlerinin %81,6’sı hastaların dental tedavilerini de yapmıştır. Meslekteki yılı 10 yıldan fazla olan hekimler, tedavi yapmayı daha sık tercih etmişlerdir(p<0.05). Uzmanlık ile tedavi yapma arasındaki ilişki anlamlı bulunmuş, uzman dişhekimlerinin tamamı hastaların tedavilerini yapmışlardır (p<0.05). Pediatrik onkoloji hastalarına hekimlerinin %90’ı koruyucu, %85’i restoratif, %82,5’i cerrahi, %45’i endodontik tedavi uygulamıştır. Hekimlerin büyük çoğunluğu (%77,5), ebeveynlerin anksiyetesinden dolayı tedavi sırasında zorlandıklarını bildirmişlerdir. Sadece muayene yapan hekimlerin yaklaşık yarısı (%55,6), komplikasyon/malpraktis korkusu nedeniyle hastayı sevk ettiklerini ifade etmiştir. Pediatrik onkoloji hastalarının dental tedavileri ile ilgili eksikliklerin giderilmesi için lisans/uzmanlık eğitiminde bu konulara gereken önemin verilmesi ve meslek içi eğitimlere ağırlık verilerek diş hekimlerinin mevcut bilgilerinin güncellenmesi gerektiği sonucuna varılmıştır.

Kaynakça

  • 1. Bergmann OJ. Oral infections and septicemia in immunocomprimised patient with haemotoligical malignancies. J Clin Microbiol. 1988;10:2105-9. 2. Bergmann OJ. Oral infections and fever in immunocomprimised patients with haemotoligical malignancies. Eur J Clin Infec Dis. 1989;3:207-13.
  • 3. Keene HJ, Fleming TJ, Toth BB. Cariogenic microflora in patients with Hodgkin’s disease before and after mantle field radiotherapy. Oral Surg. 1994:78:577-81.
  • 4. Clinical Affairs Committee- Pulp Therapy Subcommittee. Guidelines on pulp therapy for primary and immature permanent teeth. Revised: 1998, 2001, 2004 and 2009.
  • 5. Kırzıoğlu Z, Tasa T. Kanser tanısı alan çocuk hastalarda oral sağlığın sağlanması. Cumhuriyet Dent J. 2015;18:300-10.
  • 6. Clinical Affairs Committee. Clinical Guideline on Dental Management of Pediatric Patients Receiving Chemotheraphy, Hematopoetic Cell Transplantation, and/or Radiation. The American Academy of Pediatric Dentistry 2008:253-8.
  • 7. Halperson E, Moss D, Tickotsky N, et al. Dental pulp therapy for primary teeth in children undergoing cancer therapy. Pediatric blood & cancer 2014;61:2297-301.
  • 8. Hong CH, Hu S, Haverman T, et al. (2018). A systematic review of dental disease management in cancer patients. Supportive Care in Cancer 2018;26:155-74.
  • 9. Guideline on dental management of pediatric patients receiving chemotherapy, hematopoietic cell transplantation, and/or radiation therapy. Pediatr Dent. 2016;38:334-42.
  • 10. Hong CH, da Fonseca M. Considerations in the pediatric population with cancer. Dent Clin North Am. 2008;52:155-81.
  • 11. Little JW, Falace DA, Miller CS, Rhodus NL. Cancer and oral care of the cancer patient. In: Little and Falace’s Dental Management of the Medically Compromised Patient, 8th ed. St. Louis, Mo: Elsevier-Mosby; 2012: 459-92.
  • 12. Sonis ST. Mucositis as a biological process: a new hypothesis for the development of chemotherapy- induced stomatotoxicity. Oral Oncol. 1998;34:39-43.
  • 13. Lalla RV, Brennan MT, Schubert MM. Oral complications of cancer therapy. In: Yagiela JA, Dowd FJ, Johnson BS, Marrioti AJ, Neidle EA, eds. Pharmacology and Therapeutics for Dentistry. 6th ed. St. Louis, Mo: Mosby-Elsevier; 2011:782-98.
  • 14. Balis FM, Holcenberg JS, Blaney SM. General principles of chemotherapy. In: Pizzo PA, Poplack DG, eds. Principles and Practice of Pediatric Oncology. 4th ed. Philadelphia: Lippincott Williams & Wilkins, 2002:237- 308.
  • 15. Schubert MM, Peterson DE. Oral complications of hematopoietic cell transplantation. In: Appelbaum RF, Forman SJ, Negrin RS, Blume KG, eds. Thomas’ Hematopoietic Cell Transplantation: Stem Cell Transplantation, 4th ed. Oxford, UK: Wiley-Blackwell; 2009:1589-607.
  • 16. Burden D, Mullaly B, Sandler J. Orthodontic treatment of patients with medical disorders. Eur J Orthod. 2001;23:363-72.
  • 17. Tuncer BB. Medikal Sorunlu Bireylerde Ortodontik Yaklaşımlar. Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi 2005;3:40-51.
  • 18. Sheller B, Williams B. Orthodontic management of patients with hematologic malignancies. Am J Orthod Dentofacial Orthop. 1996;109:575-80.
  • 19. Greenberg MS, Cohen SG, McKitrick JC, et al. The oral flora as a source of septicemia in patients with acute leukemia. Oral Surg Oral Med Oral Pathol. 1982;53:32-6.
  • 20. Korkut E. Pediatrik onkoloji hastalarinda dental yaklaşım. Selcuk Med J. 2016;33:39-44.
  • 21. Denys D, Kaste SC, Kun LE, et al. The effects of radiation on craniofacial skeletal growth: a quantitative study. Int J Pediatr Otorhinolaryngol. 1998;15:7-13.
  • 22. Karsila-Tenovuo S, Jahnukainen K, Peltomaki T, et al. Disturbances in craniofacial morphology in children treated for solid tumors. Oral Oncol. 2001;37:586-92.
  • 23. Otmani N. Oral and maxillofacial side effects of radiation therapy in children. J Can Dent Assoc. 2007;73:257-61.
  • 24. Sheller B, Williams B. Orthodontic management of patients with hematologic malignancies. Am J Orthod Dentofacial Orthop. 1996;109:575-80.
  • 25. Dahllöf G, Jönsson A, Ulmner M, et al. Orthodontic treatment in long-term survivors after bone marrow transplantation. Am J Orthod Dentofacial Orthop. 2001;120:459-65.
  • 26. Zahrowski JJ. Bisphosphonate treatment: An orthodontic concern for a proactive approach. Am J Orthod Dentofacial Orthop. 2007;131:311-20.
  • 27. Collard MM, Hunter ML. Dental care in acute lymphoblastic leukaemia: experiences of children and attitudes of parents. Int J Paediatr Dent. 2001;11:274-80.
  • 28. Avşar A, Hazar Bodrumlu E. Çocukluk çağı kanser hastalarının dental bakımında ailelerin yaklaşımı. EÜ Dişhek Fak Derg. 2015;36:139-42.

The Dentists’ Approach to Dental Treatments in Pediatric Oncology Patients

Yıl 2020, Ağız Kanserleri Özel Sayısı, 50 - 57, 28.09.2020
https://doi.org/10.20515/otd.769424

Öz

Today, the majority of patients receiving oncology treatment are in the pediatric population. Dentists have a great role in preventing, treating and maintaining possible complications that may occur during oncology treatment. In this study, it was aimed to evaluate the approaches of dentists’ to dental treatments in pediatric oncology patients. A 20-question questionnaire including demographic information and dental treatment approaches in pediatric oncology patients was prepared. 112 dentists were included in the study. Statistical analysis were performed by SPSS Version23. Before oncology treatment,69.6% of dentists stated that endodontic treatment should be applied to symptomatic permanent teeth,37.5% to asymptomatic permanent teeth, 33% to symptomatic primary teeth. 69.6% of dentists stated that all mobile primary teeth should be removed.43.8% of dentists examined at least one pediatric oncology patient throughout their professional life, 81.6% of these dentists also performed dental treatments. Dentists with more than 10 years in the profession preferred to do treatment more frequently (p<0.05).The relationship between specialization and treatment was found to be significant(p<0.05). 90% of dentists applied preventive, 85% restorative, 82.5% surgical, 45% endodontic treatments. The vast majority of dentists (77.5%) reported that they had difficulty due to parents’ anxiety during treatments. Approximately half of the dentists(55.5%) who examined only, stated that they referred patients due to fear of complications/malpractice. In order to overcome the deficiencies related to dental treatments of pediatric oncology patients,it has been concluded that the necessary importance should be given to these issues in undergraduate/specialist education and the current knowledge of dentists should be updated.

Kaynakça

  • 1. Bergmann OJ. Oral infections and septicemia in immunocomprimised patient with haemotoligical malignancies. J Clin Microbiol. 1988;10:2105-9. 2. Bergmann OJ. Oral infections and fever in immunocomprimised patients with haemotoligical malignancies. Eur J Clin Infec Dis. 1989;3:207-13.
  • 3. Keene HJ, Fleming TJ, Toth BB. Cariogenic microflora in patients with Hodgkin’s disease before and after mantle field radiotherapy. Oral Surg. 1994:78:577-81.
  • 4. Clinical Affairs Committee- Pulp Therapy Subcommittee. Guidelines on pulp therapy for primary and immature permanent teeth. Revised: 1998, 2001, 2004 and 2009.
  • 5. Kırzıoğlu Z, Tasa T. Kanser tanısı alan çocuk hastalarda oral sağlığın sağlanması. Cumhuriyet Dent J. 2015;18:300-10.
  • 6. Clinical Affairs Committee. Clinical Guideline on Dental Management of Pediatric Patients Receiving Chemotheraphy, Hematopoetic Cell Transplantation, and/or Radiation. The American Academy of Pediatric Dentistry 2008:253-8.
  • 7. Halperson E, Moss D, Tickotsky N, et al. Dental pulp therapy for primary teeth in children undergoing cancer therapy. Pediatric blood & cancer 2014;61:2297-301.
  • 8. Hong CH, Hu S, Haverman T, et al. (2018). A systematic review of dental disease management in cancer patients. Supportive Care in Cancer 2018;26:155-74.
  • 9. Guideline on dental management of pediatric patients receiving chemotherapy, hematopoietic cell transplantation, and/or radiation therapy. Pediatr Dent. 2016;38:334-42.
  • 10. Hong CH, da Fonseca M. Considerations in the pediatric population with cancer. Dent Clin North Am. 2008;52:155-81.
  • 11. Little JW, Falace DA, Miller CS, Rhodus NL. Cancer and oral care of the cancer patient. In: Little and Falace’s Dental Management of the Medically Compromised Patient, 8th ed. St. Louis, Mo: Elsevier-Mosby; 2012: 459-92.
  • 12. Sonis ST. Mucositis as a biological process: a new hypothesis for the development of chemotherapy- induced stomatotoxicity. Oral Oncol. 1998;34:39-43.
  • 13. Lalla RV, Brennan MT, Schubert MM. Oral complications of cancer therapy. In: Yagiela JA, Dowd FJ, Johnson BS, Marrioti AJ, Neidle EA, eds. Pharmacology and Therapeutics for Dentistry. 6th ed. St. Louis, Mo: Mosby-Elsevier; 2011:782-98.
  • 14. Balis FM, Holcenberg JS, Blaney SM. General principles of chemotherapy. In: Pizzo PA, Poplack DG, eds. Principles and Practice of Pediatric Oncology. 4th ed. Philadelphia: Lippincott Williams & Wilkins, 2002:237- 308.
  • 15. Schubert MM, Peterson DE. Oral complications of hematopoietic cell transplantation. In: Appelbaum RF, Forman SJ, Negrin RS, Blume KG, eds. Thomas’ Hematopoietic Cell Transplantation: Stem Cell Transplantation, 4th ed. Oxford, UK: Wiley-Blackwell; 2009:1589-607.
  • 16. Burden D, Mullaly B, Sandler J. Orthodontic treatment of patients with medical disorders. Eur J Orthod. 2001;23:363-72.
  • 17. Tuncer BB. Medikal Sorunlu Bireylerde Ortodontik Yaklaşımlar. Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi 2005;3:40-51.
  • 18. Sheller B, Williams B. Orthodontic management of patients with hematologic malignancies. Am J Orthod Dentofacial Orthop. 1996;109:575-80.
  • 19. Greenberg MS, Cohen SG, McKitrick JC, et al. The oral flora as a source of septicemia in patients with acute leukemia. Oral Surg Oral Med Oral Pathol. 1982;53:32-6.
  • 20. Korkut E. Pediatrik onkoloji hastalarinda dental yaklaşım. Selcuk Med J. 2016;33:39-44.
  • 21. Denys D, Kaste SC, Kun LE, et al. The effects of radiation on craniofacial skeletal growth: a quantitative study. Int J Pediatr Otorhinolaryngol. 1998;15:7-13.
  • 22. Karsila-Tenovuo S, Jahnukainen K, Peltomaki T, et al. Disturbances in craniofacial morphology in children treated for solid tumors. Oral Oncol. 2001;37:586-92.
  • 23. Otmani N. Oral and maxillofacial side effects of radiation therapy in children. J Can Dent Assoc. 2007;73:257-61.
  • 24. Sheller B, Williams B. Orthodontic management of patients with hematologic malignancies. Am J Orthod Dentofacial Orthop. 1996;109:575-80.
  • 25. Dahllöf G, Jönsson A, Ulmner M, et al. Orthodontic treatment in long-term survivors after bone marrow transplantation. Am J Orthod Dentofacial Orthop. 2001;120:459-65.
  • 26. Zahrowski JJ. Bisphosphonate treatment: An orthodontic concern for a proactive approach. Am J Orthod Dentofacial Orthop. 2007;131:311-20.
  • 27. Collard MM, Hunter ML. Dental care in acute lymphoblastic leukaemia: experiences of children and attitudes of parents. Int J Paediatr Dent. 2001;11:274-80.
  • 28. Avşar A, Hazar Bodrumlu E. Çocukluk çağı kanser hastalarının dental bakımında ailelerin yaklaşımı. EÜ Dişhek Fak Derg. 2015;36:139-42.
Toplam 27 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm ORİJİNAL MAKALELER / ORIGINAL ARTICLES
Yazarlar

Burcu Güçyetmez Topal 0000-0002-9932-9169

Yayımlanma Tarihi 28 Eylül 2020
Yayımlandığı Sayı Yıl 2020 Ağız Kanserleri Özel Sayısı

Kaynak Göster

Vancouver Güçyetmez Topal B. Diş Hekimlerinin Pediatrik Onkoloji Hastalarındaki Dental Tedavilere Yaklaşımları. Osmangazi Tıp Dergisi. 2020;42(5):50-7.


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