Impact of an Educational and Preventive Program on Oral Health Status of Pediatric Oncology Patients

Objectives: The purpose of this longitudinal interventional study was to evaluate the impact of an educational and preventive program on oral health status, and on the occurrence of oral mucositis in children and adolescents with cancer.
Methods: The sample was composed of 27 pediatric oncology patients underwent antineoplastic treatment in a referral hospital in João Pessoa, Brazil, and their parents/caregivers, from April to October 2018. The children and adolescents were evaluated before (baseline) and after the institution of the program. The parameters recorded were Visible Plaque Index (VPI), Modified Gingival Index (MGI) and the Oral Assessment Guide (OAG) modified, for five weeks, by a calibrated researcher (Kappa Index>0.75). The activities of the program included audiovisual resources, storytelling and play instruments for oral health education of patients and their parents/caregivers. Data were analyzed by normality test (Shapiro-Wilk) and compared by Wilcoxon rank sum test, Pearson's Chi-square or Fisher's exact test (α=0.05).
Results: The VPI and MGI were higher before the institution of the oral health program (baseline: VPI - 54.11±19.92%; MGI - 0.82±0.58, respectively) and in the following weeks there was a significant reduction in biofilm accumulation and gingival inflammation (VPI and MGI, respectively: 1st week - 19.62±12.53%; 0.38±0.44; 2nd week - 19.42±17.21%; 0.24±0.31; 3rd week - 18.10±9.75%; 0.29±0.36; 4th week - 15.81±14.09%; 0.26±0.31; 5th week - 26.0±19.4%; 0.44±0.53) - p<0.05. Severe oral mucositis (3 and 4 scores of OAG) was more prevalent in the second follow-up week (33.3%) and with no increase in its incidence in subsequent weeks (1st - 11.1%; 3rd - 22.7%; 4th - 14.3%; 5th - 20.8%; p>0.05).
Conclusions: It was concluded that there was an improvement in the oral health conditions of pediatric oncology patients underwent antineoplastic treatment during the period of follow-up, showing a positive impact of the program.