Oral Complications of Dental Prosthetic for Patients after Chemotherapy and Radiotherapy Treatment

Chemotherapy- and radiotherapy-induced oral complication represents a therapeutic challenge frequently encountered in cancer patients. This side effect causes significant morbidity and may delay the treatment plan, as well as increase therapeutic expenses. The current study aimed to measure possible changes in oral microflora in cancer patients wearing dentures before starting and within 3 and 7 days of the first course of chemo/radiotherapy. The researcher seeks to investigate the association between these changes and the distressing oral problems compared with control patients.

The current study performed based on the case-control design in which 46 cancer patients who wear dentures and meet the inclusion criteria were selected from 80 patients as cases or tested group. Another 46 cancer patients who did not wear dentures were matched to be the control group. Based on the international safety standard, the oral microflora of the buccal mucosa was collected and cultured from two saliva samples at T0 (before chemotherapy), T1 (the day after chemotherapy), and T2 (7 days after chemotherapy). A series of descriptive and MacNemar analysis and other statistical tests included independent and paired t-tests, chi-square, were performed to determine significance at P < 0.05.

The current study revealed that that 25 patients (54.34%) who developed plaque that consisted predominantly of saprophytic Gram-positive cocci (Streptococcus spp., Leuconostoc spp., Granulicatella spp. and Gemella spp.). By investigation, 15 of these patients underwent chemotherapy/radiotherapy (60%). The other 21 patients (45.66%) developed periodontal pathogens (F. nucleatum, P. gingivalis, Actinobacillus spp. and Pep. micros). Regarding time variation (T0, T1, and T2), no significant differences were reported in bacterial changes. Furthermore, the control group swabs showed that the bacterial count did not change significantly during the observation period and both qualitative and quantitative bacterial growth was not significantly differed from the case group.

The results of the current study indicate that there were no significant changes in the growth of microflora observed in the dental plaque and wearing dental of cancer patients within 7 days of the first course of chemo/radiotherapy. Furthermore, no correlation observed between oral mucositis and specific microorganisms.