terça-feira, 17 de junho de 2014

Oral complaints and dental care of haematopoietic stem cell transplant patients: a qualitative survey of patients and their dentists

Abstract

Purpose

Little is known about the understanding of the oral and dental needs of haematopoietic stem cell transplant (HSCT) patients or about dentists’ views and experiences regarding this patient group. This information is essential if we want to improve the standard of peri-HSCT dental care.
The primary objective of this qualitative survey was to explore the following:
  1. The understanding of dental care pre- and post-HSCT
  2. The subjective oral complaints of HSCT patients both short- and long-term
  3. The relationship of these oral complaints to the severity of oral mucositis during hospitalization
The secondary objective was to explore the opinions of dentists regarding dental care before and after HSCT.

Patients and methods

All adult patients who survived HSCT at the Radboud University Medical Centre between 2010 and 2011 (n = 101) received a questionnaire. During hospitalization, mucositis scores were recorded daily in the patient’s chart. The patients’ dentist (n = 88) was also sent a questionnaire after permission of the patient.

Results

Ninety-six out of 101 patients (95 %) responded. The average period since HSCT was 19 months (range 8–31 months). The overall mean maximum mucositis score was 6.6 (sd = 3.3). Only eight patients reported not having visited a dentist pre-HSCT. The majority of the patients (59 %) reported short-term oral complaints, and 28 % reported long-term oral complaints. Fifty-two dentists responded (59 %). Nine had not performed pre-HSCT screening and eight dentists reported screening their patients but could not complete the necessary treatments. Only 44 dentists succeeded in completing the required treatments. The most important advice of the dentist was to reinforce the importance of regular dental care.

Conclusion

Most patients report short-term and/or long-term oral complaints after HSCT. Most dentists stress the importance of regular dental care before and after HSCT but report not being familiar with the particular dental care needs of this patient group. The high response rate and the high rate of HSCT-related oral complaints emphasize the need of further research in this area.

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