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ORAL CARE FOR PATIENTS UNDERGOING CHEMOTHERAPY AND RADIATION THERAPY

Dentaid Solutions

10 Jul 2019

Before beginning radiation therapy or chemotherapy, patients should be examined and treated for any oral diseases that may be a source of infection during antineoplastic therapy. 

In addition, they must be instructed on how to properly perform oral hygiene to thereby limit the build-up of dental plaque or biofilm to the extent possible during treatment. 

In any case, due to the almost inevitable occurrence of mucositis, mechanical oral hygiene will be more complicated, and for this purpose chemical plaque control methods with antiseptics may be used. The most important is chlorhexidine, a broad-spectrum antiseptic, bactericide and fungicide with a substantivity of up to 12 hours. 

Likewise, it has been demonstrated that by adding another antiseptic, such as cetylpyridinium chloride, synergy between the two compounds is produced and the product’s final effectiveness increases both in vitro and in vivo. This is the case of Perio·Aid®, which also does not contain alcohol and so it does not dry the mucosa, a crucial advantage for these patients. 

Multiple scientific studies have shown that Perio·Aid® is equally effective for the microbiological control of periodontopathogenic bacterial species during radiation therapy, as well as for controlling any overgrowth of opportunistic species such as Candida sp. It may also be useful for treating osteonecrosis of the jaw caused by intravenous therapies with bisphosphonates. 

When treating chemotherapy-induced ulcers, the application of a bioadhesive gel with chlorhexidine, hyaluronic acid and panthenol, such as Perio·Aid® Bioadhesive Gel, may help improve healing and reduce pain. 

Another of the most common complications in patients receiving treatment for cancer is xerostomia, or dry mouth, which can greatly impact quality of life. To relieve xerostomia symptoms and stimulate natural saliva production, the DENTAID® Xeros formula was developed, incorporating amongst other compounds, malic acid, a sialagogue or stimulator of saliva production; xylitol, which also stimulates saliva production and has an anti-caries effect; and betaine, a moisturising and lubricating agent. 

Additionally, the saliva’s own antibacterial activity confers even greater importance to the need for stimulation of natural saliva secretion, rather than replacing it with saliva substitutes whose protection is nowhere near that provided by the components in natural saliva. 

The effectiveness of the DENTAID® Xeros formula has been proven by many studies. A recent research study tested the capacity for saliva stimulation of the tablets, and it was suggested that they could have an anti-erosion effect by remineralising the teeth with fluoride. 

In another study performed with elderly xerostomia patients, it was also shown that DENTAID® Xeros spray is able to increase the rate of both natural and stimulated saliva production. Moreover, DENTAID® Xeros oral hygiene products do not contain the detergent sodium lauryl sulfate, which can act as an irritant in these patients. 

Bibliography

  1. Herrera D, y cols. Differences in antimicrobial activity of four commercial 0.12% chlorhexidine mouthrinse formulations: an in vitro contact test and salivary bacterial counts study. J Clin Periodontol 2003; 30: 307-314. 
  2. .Lanzós I, y cols. Microbiological effects of an antiseptic mouthrinse in irradiated cancer patients. Med Oral Patol Oral Cir Bucal 2011; 16 (7): 1.036-1.042. 
  3. Fathilah AR, y cols. The antifungal properties of chlorhexidine digluconate and cetylpyrinidinium chloride on oral Candida. J Dent 2012; 40 (7): 609-615. 
  4. Gómez-Moreno G, y cols. Bisphosphonate-associated osteonecrosis of the jaw 2 years after teeth extractions: a case report solved with non-invasive treatment. Eur Rev Med Pharmacol Sci 2014; 18 (9): 1.391-1.397. 
  5. Da Mata AD, y cols. Effects of gustatory stimulants of salivary secretion on salivary pH and flow: a randomized controlled trial. Oral Dis 2009; 15 (3): 220-228. 
  6. Gómez-Moreno G, y cols. Evaluation of the efficacy of a topical sialogogue spray containing malic acid 1% in elderly people with xerostomia: a double-blind, randomized clinical trial. Gerodontology 2013; 1: 1-7.

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