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122 rev port estomatol med dent cir maxilofac. 2019;60(3):118-124

Table 4. Association between quality of life during chemotherapy and the number of oral manifestations, based on the
Kruskal-Wallis test.
Number of oral manifestations
p value
0 1 2 3 4 5
n (%) n (%) n (%) n (%) n (%) n (%)
Not affected 4 (57.1) 3 (30.0) 4 (30.8) 1 (8.3) 0 (0.0) 0 (0.0)
Quality Slightly
of life affected 3 (42.9) 4 (40.0) 6 (46.2) 5 (41.7) 1 (16.7) 0 (0.0) 0.002*
during CT
Very much 0 (0.0) 3 (30.0) 3 (23.1) 6 (50.0) 5 (83.3) 1 (100.0)
affected
*statistically significant; CT, chemotherapy.

Table 5. Association between dental appointments before and during chemotherapy and the number of oral
manifestations.
Number of oral manifestations
0 1 2 3 4 p value
n (%) n (%) n (%) n (%) n (%)

1 1 (14.3) 1 (11.1) 0 (0.0) 1 (10.0) 2 (40.0)
OHI-s † 2 5 (71.4) 6 (66.7) 10 (90.9) 8 (80.0) 1 (20.0) 0.603
3 1 (14.3) 2 (22.2) 1 (9.1) 1 (10.0) 2 (40.0)

Yes 3 (42.9) 4 (40.0) 9 (69.2) 8 (66.7) 2 (33.3)
Dental appointment 0.821
before CT ‡
No 4 (57.1) 6 (60.0) 4 (30.8) 4 (33.3) 4 (66.7)

Dental appointment Yes 1 (14.3) 1 (10.0) 0 (0.0) 3 (25.0) 0 (0.0) 0.987
during CT ‡
No 6 (85.7) 9 (90.0) 13 (100.0) 9 (75.0) 6 (100.0)
‡
† Kruskal-Wallis test; Mann-Whitney U test; OHI-s, simplified oral hygiene index; CT, chemotherapy.

The quality of life during CT was significantly associated Regarding the first aim of the study, many oral manifesta-
with the number of oral manifestations (p=0.002) (Table 4). The tions and symptoms were found in onco-hematology patients
value of the Pearson ρ was 0.521 (p<0.001), indicating a mod- during CT. One study had reported that, after one week of CT
5
erate correlation between these two variables, which means treatment, oral symptoms increased, with mucositis, pain,
that patients whose quality of life was more affected had a dysphagia, mouth and lip dryness, dysgeusia, gingival bleeding
higher number of oral manifestations. and the ability to talk being frequently reported. The same oral
The number of oral manifestations was not associated with manifestations were found in the present study as well as in
the presence of dental debris and calculus (p=0.603) nor with the others. 18,19 Oral ulcers were reported by one-third of the study
use of dental services before CT (p= 0.821) or during CT (p=0.987) participants but observed in one-quarter. This prevalence of
20
(Table 5). There was also a negative correlation, although not oral ulcers is much higher than that of patients not doing CT.
statistically significant (p=0.25), between the number of oral In a previous study, this condition increased by 22% during the
5
manifestations and the oral hygiene instructions received. CT cycle. Gingival inflammation and red/white lesions were
also more frequent in the onco-hematology patients of this
20
study than healthy subjects. Mucositis was observed in about
Discussion one-fifth of the sample, while other studies had reported high-
er and lower frequencies of mucositis. 7,19 Difficulty in feeding
This observational study was conducted in an adult popula- was less observed in the present study as compared to others. 5
tion undergoing CT, to investigate the oral manifestations and Several CT-related side effects are dependent on the phase
symptoms during CT and whether oral health routines influ- of the treatment. In the consolidating phase, where the ther-
ence the patient’s experience of oral manifestations and apy is intensified, the most common complications are muco-
symptoms and their quality of life. sitis, dysgeusia, xerostomia, bleeding, oral pain, opportunistic