The Common Complications of Chemotherapeutic Agents and the Effect of Xylitol Chewing Gum on Oral Dental Hygiene in Patients Having Malignant

Abstract

Aims: The aim of this study were to estimate the percentage of general and oral complications among patients receiving chemotherapeutic agents and correlate the oral complications with the age of the patients and with the drugs either used singly or in combination with the other chemotherapeutic agent and the effect of xylitol chewing gum on oral dental hygiene in patients having malignant diseases. Materials and Method: In this clinical trial, 70 patients with ages ranging between 7–65 years treated with different cancer chemotherapy for a duration from 3 months to 3 years. The patients were selected from those who treated in Hazim Al–Hafith center for treatment cancer in Mosul City. General and oral complications of chemotherapeutic agents were recorded and the agent recorded either used singly or in combination with the other chemotherapeutic agent. Twenty patients from those who had oral complications were examined and the plague and gingival indices were measured according to Silness and Loe (1963) at the base line. Then those patients were instructed to take xylitol chewing gum (4 grams/day); four times immediately after eating. The plague and gingival indices were measured again after 3 weeks of using the chewing gum. Results: The results of this study revealed that approximately half of the patients have general and oral complications while the others either had only general complications or had no complications (48.57%, 27.14%, 24.29% respectively). The incidence of oral complications correlated with the increasing in patients' age (P<0.01). The distribution of general and oral complications were correlated with the agent used either singly or in combination, where 100% of patients medicated with single therapy had general and oral complications while the patients medicated with multiple therapy 70.69% of them had general and oral complications and 29.13% had no significant complications. The patients who had taken xylitol chewing gum had a significant reduction in plague index while there is no significant reduction in gingival index (p<0.01). Conclusions: the study concluded that the general and oral complications arising in cancer patients can be attributed to the various modalities of cancer chemotherapy. Routine oral hygiene and elimination of preexisting dental disease and sources of mucosal irritation with a giving of salivary substitutes like xylitol reduce the incidence and severity of a number of oral complications of chemotherapy.