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Volume 17, Issue 4 (December-2025 2025)
Iranian Journal of Blood and Cancer 2025, 17(4): 47-52 |
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Abdolkarimi B, Amanati A, Derikvand N, Panahi N, Mirzaie S. Clinical Guidelines for the Prevention and Management of Oral and Dental Complications in Pediatric Oncology Patients: A Narrative Review. Iranian Journal of Blood and Cancer 2025; 17 (4) :47-52
URL: http://ijbc.ir/article-1-1855-en.html
URL: http://ijbc.ir/article-1-1855-en.html
1- Department of pediatric, Hakim children hospital, Tehran university of medical science, Tehran, Iran.
2- Clinical Research Development Center, Amir Oncology Hospital, Shiraz University of Medical Sciences, Shiraz, Iran. & Professor Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. ,Dr.amanati14@gmail.com
3- Department of Periodontics, Bo.c., Islamic Azad University, Borujerd, Iran.
4- Azad Islamic university, science and research branch, Tehran, Iran.
2- Clinical Research Development Center, Amir Oncology Hospital, Shiraz University of Medical Sciences, Shiraz, Iran. & Professor Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. ,
3- Department of Periodontics, Bo.c., Islamic Azad University, Borujerd, Iran.
4- Azad Islamic university, science and research branch, Tehran, Iran.
Abstract: (304 Views)
Background: Oral complications are among the most frequent and debilitating adverse effects of cancer therapy in pediatric patients. Chemotherapy, radiotherapy, and hematopoietic stem cell transplantation can result in acute manifestations such as mucositis, infections, bleeding, and pain, as well as long-term sequelae including dental developmental abnormalities, craniofacial growth disturbances, and xerostomia. Comprehensive oral care is therefore a critical component of supportive oncology management.
Objectives: This narrative review aims to summarize current evidence regarding oral and dental care strategies for pediatric oncology patients, focusing on preventive assessment, hygiene maintenance, management of treatment-related complications, and long-term follow-up.
Methods: Relevant literature was reviewed to consolidate clinical recommendations and evidence-based strategies for oral care in children undergoing oncology treatment. The review highlights practical approaches for pre-treatment dental evaluation, in-treatment oral hygiene and infection control, and post-treatment follow-up, with integration of levels of evidence where available.
Results: Pre-treatment dental assessment and elimination of infectious foci significantly reduce oral and systemic complications. During active therapy, gentle oral hygiene practices, fluoride use, antiseptic rinses, and careful management of pain and infection are essential. Oral mucositis remains the most common dose-limiting complication, and preventive strategies such as cryotherapy, keratinocyte growth factors, and low-level laser therapy demonstrate strong supporting evidence. Post-treatment follow-up should include regular dental visits, ongoing preventive care, and monitoring for late sequelae such as dental developmental anomalies and xerostomia.
Conclusions: Structured oral care, encompassing pre-treatment assessment, active therapy management, and long-term follow-up, is essential to minimize morbidity and improve quality of life in pediatric oncology patients. Evidence-based interventions, particularly for mucositis prevention and caries management, provide a foundation for standardized clinical practice and highlight areas for future research.
Objectives: This narrative review aims to summarize current evidence regarding oral and dental care strategies for pediatric oncology patients, focusing on preventive assessment, hygiene maintenance, management of treatment-related complications, and long-term follow-up.
Methods: Relevant literature was reviewed to consolidate clinical recommendations and evidence-based strategies for oral care in children undergoing oncology treatment. The review highlights practical approaches for pre-treatment dental evaluation, in-treatment oral hygiene and infection control, and post-treatment follow-up, with integration of levels of evidence where available.
Results: Pre-treatment dental assessment and elimination of infectious foci significantly reduce oral and systemic complications. During active therapy, gentle oral hygiene practices, fluoride use, antiseptic rinses, and careful management of pain and infection are essential. Oral mucositis remains the most common dose-limiting complication, and preventive strategies such as cryotherapy, keratinocyte growth factors, and low-level laser therapy demonstrate strong supporting evidence. Post-treatment follow-up should include regular dental visits, ongoing preventive care, and monitoring for late sequelae such as dental developmental anomalies and xerostomia.
Conclusions: Structured oral care, encompassing pre-treatment assessment, active therapy management, and long-term follow-up, is essential to minimize morbidity and improve quality of life in pediatric oncology patients. Evidence-based interventions, particularly for mucositis prevention and caries management, provide a foundation for standardized clinical practice and highlight areas for future research.
Keywords: Pediatric oncology, Oral care, Dental management, Mucositis, Chemotherapy, Radiotherapy, Supportive care
: Review Article |
Subject:
Pediatric Hematology & Oncology
Received: 2025/11/19 | Accepted: 2025/12/24 | Published: 2025/12/30
Received: 2025/11/19 | Accepted: 2025/12/24 | Published: 2025/12/30
References
1. Tanboga I, Durmus B, Karakas Z, Saribeyoglu E, Yalcinkaya D, Trosala SC, Guven Y. Xerostomia management for pediatric oncology patients with lactoperoxidase included oral health care products. Dent J. 2012;3:158. doi: 10.4172/2161-1122.1000158. [DOI:10.4172/2161-1122.1000158]
2. Carrillo C, Vizeu H, Soares-Júnior LA, Fava M, Odone Filho V. Dental approach in the pediatric oncology patient: characteristics of the population treated at the dentistry unit in a pediatric oncology Brazilian teaching hospital. Clinics. 2010;65(6):569-73. doi: 10.1590/S1807-59322010000600002. [DOI:10.1590/S1807-59322010000600002]
3. Frascino AV, Fava M, Cominato L, Odone-Filho V. Review of a three-year study on the dental care of onco-hematological pediatric patients. Clinics (Sao Paulo). 2018;73:e721. doi: 10.6061/clinics/2017/e721. [DOI:10.6061/clinics/2017/e721]
4. Lopes MC, Teixeira MG, Jacob Filho W, Carvalho Filho ET, Habr-Gama A, Pinotti HW. Prevalence of anal incontinence in the elderly population: an epidemiological study of the elderly population served at the geriatric ambulatory service of the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Rev Hosp Clin Fac Med Sao Paulo. 1997;52(1):1-12. PMID: 9334464.
5. dela Cruz GG, Rozier RG, Slade GD. Dental screening and referral of young children by pediatric primary care providers. Pediatrics. 2004;114(5):e642-52. doi: 10.1542/peds.2004-1269. PMID: 15520094. [DOI:10.1542/peds.2004-1269]
6. Lebrão ML, Litvoc J, Figueiredo GM, Leite RM. Study of morbidity in patients hospitalized at the Clinic Hospital at the Medical School of the USP-1989. Rev Hosp Clin Fac Med Sao Paulo. 1993;48(4):189-98. PMID: 8284592.
7. Schout D, Hajjar LA, Galas FR, Uip DE, Levin AS, Caiaffa Filho HH, et al. Epidemiology of human infection with the novel virus influenza A (H1N1) in the Hospital das Clínicas, São Paulo, Brazil-June-September 2009. Clinics (Sao Paulo). 2009;64(10):1025-30. doi: 10.1590/S1807-59322009001000014. [DOI:10.1590/S1807-59322009001000014]
8. Gandhi K, Datta G, Ahuja S, Saxena T, Datta A. Prevalence of oral complications occurring in a population of pediatric cancer patients receiving chemotherapy. Int J Clin Pediatr Dent. 2017;10(2):166-71. doi: 10.5005/jp-journals-10005-1428. PMID: 28890617. [DOI:10.5005/jp-journals-10005-1428]
9. Mortazavi H, Tashvighi M, Azizian M, Khalighi HR, Sabour S, Movahhedian A, Baharvand M, et al. Evaluation of relationship between demographics and dental status in a defined group of Iranian paediatric patients undergoing cancer therapy. J Clin Diagn Res. 2015;9(9):ZC80-3. doi: 10.7860/JCDR/2015/11976.6521. [DOI:10.7860/JCDR/2015/11976.6521]
10. Braga PE, Latorre MRDO, Curado MP. Câncer na infância: analise comparativa da incidência, mortalidade e sobrevida em Goiânia (Brasil) e outros países. Cad Saúde Pública. 2002;8:33-44. [DOI:10.1590/S0102-311X2002000100004]
11. Ministério da Saúde. Instituto Nacional de Câncer Coordenação de Programas de Controle do Câncer. O Problema do Câncer no Brasil. 4th ed. Rio de Janeiro; 1997.
12. Smith MA, Ries LAG. Childhood cancer: incidence, survival, and mortality. In: Pizzo PA, Poplack DG, editors. Principles and Practice of Pediatric Oncology. Philadelphia: Lippincott Williams & Wilkins; 2002. p. 1-12.
13. Effinger KE, Migliorati CA, Hudson MM, McMullen KP, et al. Oral and dental late effects in survivors of childhood cancer: a Children's Oncology Group report. Support Care Cancer. 2014;22(7):2009-19. [DOI:10.1007/s00520-014-2260-x]
14. Ribeiro IL, Limeira RR, Dias de Castro R, Ferreti Bonan PR, Valença AM. Oral and dental considerations in pediatric cancers. Int J Environ Res Public Health. 2017;14(12):1468. [DOI:10.3390/ijerph14121468]
15. Cubukcu CE, Sevinir B, Ercan I. Disturbed dental development of permanent teeth in children with solid tumors and lymphomas. Pediatr Blood Cancer. 2012;58:80-4. [DOI:10.1002/pbc.22902]
16. Kaste SC, Hopkins KP, Jones D, Crom D, Greenwald CA, Santana VM. Dental abnormalities in children treated for acute lymphoblastic leukemia. Leukemia. 1997;11:792-6. [DOI:10.1038/sj.leu.2400670]
17. van der Pas-van Voskuilen IG, Veerkamp JS, Raber-Durlacher JE, Bresters D, van Wijk AJ, et al. Long-term adverse effects of hematopoietic stem cell transplantation on dental development in children. Support Care Cancer. 2009;17:1169-75. [DOI:10.1007/s00520-008-0567-1]
18. Vaughan MD, Rowland CC, Tong X, Srivastava DK, Hale GA, Rochester R, Kaste SC. Dental abnormalities after pediatric bone marrow transplantation. Bone Marrow Transplant. 2005;36:725-9.
https://doi.org/10.1038/sj.bmt.1705111 [DOI:10.1038/sj.bmt.1705136]
19. Dahllof G, Jonsson A, Ulmner M, Huggare J. Orthodontic treatment in long-term survivors after pediatric bone marrow transplantation. Am J Orthod Dentofacial Orthop. 2001;120:459-65. [DOI:10.1067/mod.2001.118102]
20. Jensen SB, Pedersen AM, Vissink A, Andersen E, Brown CG, Davies AN, et al. Salivary gland hypofunction/xerostomia in cancer therapy: prevalence, severity, and impact on quality of life. Support Care Cancer. 2010;18:1039-60. [DOI:10.1007/s00520-010-0827-8]
21. Jensen SB, Pedersen AM, Vissink A, Andersen E, Brown CG, Davies AN, et al. Salivary gland hypofunction/xerostomia in cancer therapy: management strategies and economic impact. Support Care Cancer. 2010;18:1061-79. [DOI:10.1007/s00520-010-0837-6]
22. da Fonseca MA. Dental care of the pediatric cancer patient. Pediatr Dent. 2004;26(1):53-7.
23. Walsh LJ. Clinical assessment and management of the oral environment in the oncology patient. Aust Dent J. 2010;55 Suppl 1:66-77. doi: 10.1111/j.1834-7819.2010.01201.x. [DOI:10.1111/j.1834-7819.2010.01201.x]
24. Clinical guideline on dental management of pediatric patients receiving chemotherapy, hematopoietic cell transplantation, and/or radiation. [Internet]. 2013. Available from: http://www.aapd.org
25. American Academy of Pediatric Dentistry. Preserving oral health in cancer therapy. Pediatr Dent. 2004;26(7 Suppl):144-9. PMID: 15656454.
26. Rankin KV. Nutrition and oral health considerations in children with special health care needs: implications for oral health care providers. Tex Dent J. 2004;121(6):468-9.
27. Moursi AM, Fernandez JB, Daronch M, Zee L, Jones CL. Dental and oral care for chronically ill children and adolescents. Pediatr Dent. 2010;32(4):333-42. PMID: 20836954.
28. Hong CH, da Fonseca M. Considerations in the pediatric population with cancer. Dent Clin North Am. 2008;52(1):155-81. doi: 10.1016/j.cden.2007.10.001. [DOI:10.1016/j.cden.2007.10.001]
29. Redding SW. Oral complications of cancer therapy. Tex Med. 2003;99(5):54-7. PMID: 12772642.
30. Mubaraki S, Pani SC, Alseraihy A, Abed H, Alkhayal Z. The efficacy of two different oral hygiene regimens on the incidence and severity of oral mucositis in pediatric patients receiving hematopoietic stem cell transplantation: a prospective interventional study. Spec Care Dentist. 2020;40(6):566-73. doi: 10.1111/scd.12525. [DOI:10.1111/scd.12525]
31. Ali MH, Nurelhuda NM. Oral health status and its determinants in children with leukemia at the Radiation and Isotope Center Khartoum, Sudan. Sudan J Paediatr. 2019;19(2):93-100. doi: 10.24911/SJP.106-1568288518. PMID: 31969737. [DOI:10.24911/SJP.106-1568288518]
32. Kowlessar A, Naidu R, Ramroop V, Nurse J, Dookie K, Bodkyn C, Lalchandani S. Prevalence of oral complications occurring in a population of pediatric cancer patients receiving chemotherapy. Clin Exp Dent Res. 2019;5(6):665-9. doi: 10.1002/cre2.23 [DOI:10.1002/cre2.23]
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