Estado de salud bucodental de los pacientes con linfoma que van a ser tratados en la Región de Murcia

Abstract

Objectives: To establish the state of oral health of patients who will be treated for lymphoma through a descriptive and analytical study of the prevalence of caries, xerostomy, periodontal status, oral hygiene and other oral pathologies in this population. To study the possible existence of associations or relationships between variables and to compare these results with those obtained by other authors, by reviewing the literature. To find out the needs of odontostomatologic treatment in this group, in order to design health programs and strategies to reduce oral complications in these patients. Methodology: Sample of 100 patients with lymphoma submitted to the Special Patient Teaching Unit of the University Dental Clinic by interconsultation from the Oncohematology Unit of the Hospital "Morales Meseguer", to who an oral examination (clinical and radiographic) was performed. The following was recorded: Pathology from mucosae and soft tissues, salivary flow and pH, dental and prosthetic situation (including rates of decay), periodontal status (CPTIN index and plaque index). Data from the medical records of the Haematology Unit and of the Bone Marrow Transplantation Unit of the Hospital "Morales Meseguer" were also collected. Results: The patient population in our study is matched in terms of gender distribution, age and type of lymphoma, with the reviewed literature; so the sample is representative. Both the dental and the periodontal health of the study sample are worse than the averages established for the Spanish population in the last Survey of Oral Health. Patients with lymphoma have a high number of parts with tooth decay and dental absences caused by the decay, than what would be expected in the general population and a low refresh rate. The number of dental absences are directly related to patient age, being higher the older the patient is; like the C.A.O and C.A.O.S indexes. The relationship in our study between these rates and the age is in our opinion, at the expense of absences. Periodontal health is very poor and the patient is not aware of maintaining his oral condition. As in the literature, and as it might be expected in a normal population, age influenced the periodontal status of our sample. Less periodontal disease was identified in younger people and more serious periodontal pathologies at older ages. The level of oral and periodontal health of patients with lymphoma treated in the region of Murcia, despite being worse than those of the population, are similar to those of other studies consulted, in which the individuals composing the samples are also suffering from other similar diseases. Some oral lesions associated with cancer therapy, such as candidiasis and ulcers appeared more frequently in older patients. Pericoronitis was more prevalent in younger patients. The cancer therapy already received by our patients had less influence in the salivary flow than expected, but it affected the pH of the saliva. The relationship between the Oncohematology and the Odontology Units should be closer. This would improve the oral health of patients before starting cancer treatment, and reduce as far as possible oral complications during cancer treatment as well as limiting the impact of such complications in the general health of the patient.