Dental Caries, Oral Mucositis and Oral-health Related- Quality-of-life in Children Undergoing Cancer Therapy at Kenyatta National Hospital

Abstract

Background: Children with cancer undergo various complex treatment modalities that predispose them to oral complications. Little is known about the prevalence of these manifestations and how they affect a child’s Oral Health-related Quality of Life (OHRQoL). Study objectives: The study sought to determine the prevalence of dental caries, oral mucositis and oral hygiene status among 3-12-year-old hospitalized children undergoing cancer therapy, and their association with the children’s OHRQoL. Study area: The study was conducted at the Kenyatta National Hospital (KNH), the specific sites being the children’s oncology wards. Study design: This was a descriptive cross-sectional study. Study population: The study population consisted of one hundred and two paediatric oncology patients aged 3-12 years who were undergoing various forms of cancer therapy at KNH. Materials and methods: The study participants were selected by purposive sampling. The inclusion criteria was all children aged 3-12-years, admitted in the oncology wards at KNH and undergoing cancer therapy. Data was collected using the WHO questionnaire on oral health surveys and clinical examination of the patients. The presence of dental caries and oral mucositis was determined using the dmft/DMFT and WHO Oral Mucositis scale indices. A validated 8-item Child Perception Questionnaire 8-10 (CPQ8-10) was used to collect data on OHQoL among the 8-12-year-old children in the study. Data analysis and presentation: Data was analysed using SPSS version 25. The results were then subjected to descriptive and inferential statistical tests. P<0.05 was considered statistically significant. The confidence interval was set at 95%. The results were presented in the form of tables and text. Results: The prevalence of dental caries was 58.8%. Age was statistically significantly associated with dental caries experience with children aged 6 – 12 years having a higher xvi odds of having dental caries compared to those aged 3 – 5 years (p=0.025). The prevalence of mucositis was 28.4%. Grade I and Grade II were the most prevalent in terms of severity, mostly affecting children who had increased chemotherapy circles. While dental caries was not associated with OHRQoL, children with oral mucositis had significantly poor OHRQoL. Conclusion: Children undergoing cancer therapy were found to suffer from a higher prevalence of dental caries than those in the general Kenyan population. They also displayed significant levels of oral mucositis which affected negatively, several domains of the children’s OHRQoL. The likelihood of developing oral mucositis increased with the increase in cancer treatment modalities and increase in number of chemotherapy cycles. Recommendation: There is a need to pay closer attention to the oral health needs of children undergoing cancer therapy. This may require the involvement of a paediatric oral health team. Information from this study may be used in the development of appropriate oral healthcare protocols for use among hospitalized children.