Orofacial complications in children undergoing cancer therapy in Hong Kong

Abstract

Objectives. To investigate the orofacial complications in children undergoing cancer therapy and to increase their awareness of oral health. Methods. A randomly selected convenient sample of 46 children aged below 18 years undergoing combination chemotherapy for hematological malignancies or solid tumors at Queen Mary Hospital were recruited. Clinical examination and a parental questionnaire survey were performed. Parents were taught about oral health and received a talk that focused on the common oral complications of cancer therapy and their management. Results. Oral mucositis presenting as erythema or ulceration, mostly on the buccal mucosa, was present in approximately one third of children. Many had dry and cracked lips with varying degrees of xerostomia. Oral hygiene was generally unsatisfactory, although the majority brushed their teeth and 60% rinsed their mouth with antiseptics. The prevalence of opportunistic infection was nonetheless very low. Only one child presented with acute pseudomembranous candidiasis and none had herpes simplex infection. Most parents or caretakers reported that their children experienced pain in the mouth during cancer therapy. Many reported that their children had difficulty in speaking, pain while swallowing, salivary changes, and a dry mouth. Other oral complications included alteration of taste, bad breath, bleeding gums, and tooth decay. Conclusion. Oral mucositis was a common complication during cancer therapy together with pain in the oral cavity, poor oral hygiene, and dental caries. Professional oral care should be mandatory before, during, and after cancer therapy.