Oral health status and selected salivary physicochemical characteristics among a group of patients with acute lymphocytic leukemia undergoing chemotherapy (longitudinal study)
DOI:
https://doi.org/10.32828/mdj.v13i1.870Keywords:
salivary antioxidant, gingival health condition, leukemic patientsAbstract
Background: Acute lymphoblastic leukemia is fast growing cancer of the white
blood cell. Chemotherapy which has been used to treat malignant conditions has a
negative impact on oral health condition among cancer patients. This
observational study was conducted to determine the level of selected salivary
physicochemical characteristics including flow rate and total antioxidant) in
addition to evaluation of oral health status (dental plaque and gingival health
condition) among a group of patients with acute lymphoblastic leukemia.
Materials and methods: The present study included thirty patients with acute
lymphoblastic leukemia aged (14-17) years old. Those patients attended Medical
City in Baghdad and were admitted to the Hematological Center at Teaching
Baghdad Hospital. All patients fullfitted certain inclusion criteria. Salivary sample
collection and oral examination were carried at three visits: the first visit was
carried out before receiving chemotherapy (at the day of admission)(baseline
data), while the second visit was carried out at the day 15 (after starting
chemotherapy), and the third visit was done at the day 30 (after starting
chemotherapy). Stimulated salivary samples were collected and salivary flow rate
was determined. Dental plaque was assessed according to criteria of plaque index
by Sillness and Lӧe (1964) and gingival health condition was assessed according
to the criteria of Modified Gingival Index for Lobene et al (1986). Salivary
samples then were chemically analyzed for the detection of salivary total
antioxidant.
Results: In this study, salivary flow rate decreased with time (visits) (1.44±0.14,
1.27±0.16, 1.02±0.53) with statistically highly significant differences (p<0.01).
On the other hand, the mean values of plaque and gingival indices increased with
time (visits) (0.89± 0.39, 1.22± 0.58, 1.82 ±0.75) (0.98± 0.49, 1.13± 0.46, 1.38
±0.84) respectively and the differences were statistically highly significant
(p<0.01). While salivary total antioxidant decreased with time (visits) (0.94±0.25,
0.92±0.21, 0.82±0.21) with statistically significant differences (p<0.05).
Conclusion: Acute lymphoblastic leukemia, its treatment and duration of treatment
have direct and indirect impact on the oral health status of leukemic patients.
Those patients had poor oral hygiene with high rate of gingivitis in addition to
change in salivary physicochemical properties, thus, an organized, comprehensive
oral health preventive and educational programs in addition to intense oral
hygiene program before and during the first month of treatment with cytotoxicdrug (chemotherapy) are essential to improve their oral health condition and
prevent oral problems and complications.
References
- Margolin JF, Steuber CP, Poplack DG. Acute lymphoblastic leukemia. In: Pizzo PA, Poplack DG, eds. Principles and Practice Oncology. 4th ed. Philadelphia: Lippincott Williams and Wilkins 2002; 489-544.
- Caudy D, Davies G. Clinical Pediatics and Child Health. 2nd ed. Pholadelphia, 2004: 319.
- Imone C, Everitt H, Kendrick T. Oxford hand book of general practice. 2nd ed. Italy 2005; 534-535.
- Yellon DM, Hausenloy DJ. Myocardial re perfusion injury. N Engl J Med 2007; 357:1121.
- Franch AM, Estere CG, Perez GS. Oral manifestations and dental management of patient with leukocyte alterations. J Clin Exp Dent 2011; 3(1): 53-59.
- Sonis ST, Fey EG. Oral complications of cancer therapy. Oncology (Williston Park) 2002; 16(5):680-6.
- Knox JJ, Puodziunas ALV, Feld R. Chemotherapy induced oral mucositis. Prevention and management. Drugs Aging 2000; 17 (4): 257-67.
- Robien K, Schubert MN, Bruemmer B, Lloid ME, Potter JD, Ulrich CM. Predictors of oral mucositis in patients receiving hemtopoietic cell transplants for chronic myelogenous leukemia. J Clin Oncol 2004; 22 (7): 1268-75.
- Dawes C. Salivary flow patterns and the health of hard and soft oral tissues. JADA 2008; 139(2): 18-24.
- Al- Kawas S, Rahim Z, Ferguson D. Potential uses of human salivary protein and peptide analysis in the diagnosis of disease. Arch Oral Biol 2012; 57(1):1-9.
- Limeback H. Comprehensive Preventive Dentistry. 3rd ed. John Wiley and Sons, 2012.
- Jensen SB, Pedersen AM, Reibel J, Nauntofte B. Xerostomia and hypofunction of the salivary gland in cancer therapy. Support Care Cancer 2003; 11 (4): 207-25.
- Symone M, San M, Lynne A, Edward P, and Kathy KH. Reactive Oxygen Species and Antioxidant Defense Mechanisms in the Oral Cavity: A Literature Review. Dentalaegis 2011; 23(1):15-20.
- Valko M, Leibfritz D, Moncol J, Cronin MTD, Mazur M, Teser J. Free radicals and antioxidants in normal physiological functions and human disease. Int J Biochem Cell Biol 2006; 39- 44- 84.
- Conklin KA. Dietary antioxidants during cancer chemotherapy: Impact on chemotherapeutic effectiveness and development of side effects. Nutri Cancer 2000; 37 (1):1-18.
- WHO. Oral health surveys basic methods. 4th ed. World Health Organazation, Geneva, Switzerland, 1997.
- Tenovuo J, Lagerlof F. Saliva. In: textbook of clinical cariology. 2nd ed. Edeters Thylstrup A and Fejerskov O. Pp. 17-43, chapter 2. Munksgaad, Copenhagen, Denmark, 1994.
- Sillness J, Loe H. Periodontal disease in pregnancy II. Acta Odontol Scand 1964; 24: 747-759.
- Lobene RR, Weatherford T, Ross NM, Lamm RA, Menaker L. A modified gingival index for use in clinical trails. Clin Prev Dent 1986; 8 (1): 3-6.
- Arbuthnot F. Denial, Selective Perception and Military Atrocities. Global research, September 22, 2010.
- Raber- Durlacher JE, Elad S, Barasch A: Oral mucositis. Oral Oncol 2010; 46 (6): 452-456.
- Chaveli Lopez B, Gavalda Esteve C, Sarrion Perez MG. Dental treatment considerations in the chemotherapy patient. J Clin Exp Dent 2011; 3 (1):31-42.
- Tunc I, Hala O, Kamer U. The acute effects of chemotherapy upon the oral cavity: Prevention and management. Turk J Cancer 2001; 31 (3): 1093-2001.
- Tiwari L. Science behind human saliva. J Nat Sc Biol Med 2011; 2 (1): 53-8.
- Peterson DE, Jones JB, Petit RG. Randomized, placebo- con- trolled trail of saforis for prevention and treatment of oral mucositis in breast cancer patients receiving anthracycline- based chemotherapy. Cancer 2007; 109 (2): 322-31.
- Vendrell Rankin K, Jones DL, Redding SW. Oral health in cancer therapy, a guide for health care professional. 3rd ed. 2010.
- Steele J, Walls A. Preventionin aging dentition. In: Murry J, Nunn J, Steele J. 4th ed. Oxford, USA, 2003.
- Meir HM, balawi IA, Meer HM, Nayel H, Al-Mobarak MF. Fever and granulocytobenia in children with acute lymphoblastic leukemia under induction therapy. Saudi Med J 2001; 22(5): 423-7.
- Hegde AM, Joshi S, Shetty S. Evaluation of oral hygiene status, salivary characteristic and dental caries experience in acute lymphoblastic leukemia (ALL) children. J Clin Pediatr Dent 2011; 35 (3): 319-23.
- Mi- Sun Kang, Jong- Suk oh, Kyung- Yi Jeong, Hyeong- Joon Kim, Je- Jung Lee, Guem- Sug Lee, Hoi- Jeong Lim, Hae- Soon Lim. Analysis of cariogenic bacteria in saliva of cancer patients. Chonnam Med J 2013; 49 (2): 75-80.
- Dalla- Donne R, Rossi R, Colombo R, Giustarini D, Milazani A. ‟ Biomarkers of oxidative stress in human disease ”. Clinical Chemistry 2006; 52 (4): 601-623.
- Kelkel M, Jacob C, Dicato M, Diederich M. Potential of dietary antioxidants resveratrol and curcumin in prevention and treatment of hematological malignancies. Molecules 2010; 15 (10): 7035-7074.
- Naz A, Shamsi TS, Sattar A, Mahboob T. Oxidative stress and total antioxidant status in acute leukemia at diagnosis and post remission induction phase. Pak J Pharm Sci 2013; 26 (6): 1123-30.
- Atheer A, Mehde, Ammar M, Yousif. Estimation of melanoaldehyde, total antioxidant capacity and some biochemical parameter in CSF and Sera in patients with acute lymphoblastic leukemia. Australian Journal of Basic and Applied Sciences 2014; 8 (5): 329-333.
- Goe L, Baysac M, Todd K, Linton J. Assessing the prevalence of dental caries among elementary school children in North Korea: a cross- sectional survey in the Kangwon province. Int J Dent Hyg 2005; 3 (3): 112-116.
- Al- Rawi NA, Al- Dafaai RR, Sammi M. Effect of chemotherapy on oral health status and salivary alkaline phosphatase among leukemic patients. J Bagh College Dentistry 2013; 25 (1): 137-139.
- Vankatesh Babu NS, Kavyashree BS. Comparative Evaluation of Oral Health Status in Children with Acute Lymphoblastic Leukemia. International Journal of Scientific Study 2015; 2 (10): 52-55.
- Kinane DF, Bartold PM. Clinical relevalance of host response of periodontitis. Periodontol 2007; 43: 278-93.
- Wyne- Amjad H, Al- Gorabi B, Al- Asiri Y, Khan N. Caries prevalence in Saudi primary school children of Riyadh and their teachers’ oral health Knowledge, attitude and practice. Saudi Med J 2002; 23 (1): 77-81.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
This work is licensed under a Creative Commons Attribution 4.0 International License.
