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A systematic review of dental disease management in cancer patients

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Abstract

Introduction

This systematic review aims to update on the prevalence of odontogenic-related infections and the efficacy of dental strategies in preventing dental-related complications in cancer patients since the 2010 systematic review.

Review method

A literature search was conducted in the databases MEDLINE/PubMed and EMBASE for articles published between 1 January 2009 and 30 June 2016. Each study was assessed by 2 reviewers and the body of evidence for each intervention was assigned an evidence level.

Results

After examination of the abstracts and full-text articles, 59 articles satisfied the inclusion criteria. The weighted prevalence of dental infections and pericoronitis during cancer therapy was 5.4 and 5.3%, respectively. The frequency of dental-related infections during intensive chemotherapy after complete, partial, and minimal pre-cancer dental evaluation/treatment protocols ranged from 0 to 4%. Protocols involving third molars extractions had the highest complications (40%).

Conclusions

In view of the low prevalence of infections and the potential for complications after third molar extractions, it is suggested that partial dental evaluation/treatment protocols prior to intensive chemotherapy; whereby minor caries (within dentin), asymptomatic third molars or asymptomatic teeth without excessive probing depth (<8 mm), mobility (mobility I or II) or with periapical lesions of <5 mm were observed; is a viable option when there is insufficient time for complete dental evaluation/treatment protocols. The use of chlorhexidine, fluoride mouth rinses as well as composite resin, resin-modified glass ionomer cement (GIC), and amalgam restorations over conventional GIC in post head and neck radiation patients who are compliant fluoride users is recommended.

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Acknowledgements

The authors thank Ms. Sim Yu Fan for helping with the statistical analyses for this manuscript. We would like to also thank Dr. Sharon Tan for assisting with the data management.

Author information

Authors and Affiliations

  1. Faculty of Dentistry, National University of Singapore, Singapore, Singapore

    Catherine H. L. Hong & Shijia Hu

  2. Department of Oral Medicine, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University, Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands

    Thijs Haverman

  3. Department of Radiation Oncology and Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands

    Monique Stokman

  4. Department of Oral Medicine, Carolinas HealthCare System, PO Box 32861, Charlotte, NC, 28232-2861, USA

    Joel J. Napeñas & Jacolien Bos-den Braber

  5. Kaiser Franz Josef Spital, Institue for Radioonkologie, Vienna, Austria

    Erich Gerber

  6. Department of Oral and Maxillofacial Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

    Margot Geuke

  7. Clinic of Hospital Dentistry, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece

    Emmanouil Vardas

  8. Department for Preventive Dentistry and Oral Microbiology, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland

    Tuomas Waltimo

  9. Department of Dentistry and Oral Health, Aarhus University, Vennelyst Boulevard 9, DK-8000, Aarhus C, Denmark

    Siri Beier Jensen

  10. Oral Medicine, Department of Odontology, University of Copenhagen, Nørre Allé 20, DK-2200, Copenhagen N, Denmark

    Siri Beier Jensen

  11. Dental Oncology Program, Health Sciences North, North East Cancer Center, 41 Ramsey Lake Road, Sudbury, ON, P3E 5J1, Canada

    Deborah P. Saunders

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  1. Catherine H. L. Hong
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  2. Shijia Hu
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  6. Jacolien Bos-den Braber
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  8. Margot Geuke
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Correspondence to Catherine H. L. Hong.

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Hong, C.H.L., Hu, S., Haverman, T. et al. A systematic review of dental disease management in cancer patients. Support Care Cancer 26, 155–174 (2018). https://doi.org/10.1007/s00520-017-3829-y

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