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O papel do médico dentista em pacientes pediátricos com doenças oncológicas
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Abstract(s)
A odontopediatria é a área da Medicina Dentária que se ocupa da promoção, prevenção e tratamento da saúde oral em crianças e adolescentes. No contexto oncológico, o “cancro infantil” refere-se às neoplasias diagnosticadas em pacientes com menos de 18 anos e representa um grande desafio médico. O cancro é uma patologia com uma alta taxa de incidência, de mortalidade e um mau prognóstico, frequentemente associadas ao diagnóstico tardio.
O médico dentista desempenha um papel fundamental na deteção precoce de doenças oncológicas relacionadas direta e indiretamente com a cavidade oral. Nesse contexto, a avaliação dentária deve ocorrer imediatamente após o diagnóstico do cancro, permitindo a realização dos tratamentos dentários antes dos oncológicos, reduzindo assim o risco de complicações orais durante e após o tratamento oncológico.
Os efeitos adversos, tanto agudos como crónicos, decorrentes do tratamento do cancro manifestam-se frequentemente na cavidade oral. Entre as alterações mais comuns destacam-se: mucosite, hemorragia oral, disgeusia, xerostomia, infeções oportunistas, disfunção das glândulas salivares, dor neuropática, cárie dentária, osteoradionecrose, trismo, bem como anomalias no desenvolvimento dentário e craniofacial.
Nas crianças, a prevalência de manifestações orais é superior à dos adultos, contribuindo significativamente para a morbilidade e, em alguns casos, para a mortalidade destes pacientes.
Segundo as diretrizes atuais, o médico dentista deve, em articulação com a equipa oncológica, realizar exames clínicos e radiológicos antes do início do tratamento oncológico. Esta avaliação tem igualmente como objetivo a implementação de medidas preventivas e a orientação do paciente e dos cuidadores quanto aos possíveis efeitos orais da doença oncológica e do respetivo tratamento.
Esses cuidados devem ser realizados dentro das instituições de cuidados oncológicos, promovendo uma colaboração eficaz entre o médico dentista e a equipa oncológica, garantindo cuidados orais especializados que contribuam para melhorar a qualidade de vida do paciente.
Pediatric dentistry is the branch of Dentistry concerned with the promotion, prevention, and treatment of oral health in children and adolescents. In the oncological context, “childhood cancer” refers to neoplasms diagnosed in patients under 18 years of age and represents a significant medical challenge. Cancer is a disease characterized by a high incidence rate, mortality, and poor prognosis, frequently associated with late diagnosis. The dentist plays a crucial role in the early detection of oncological diseases directly or indirectly related to the oral cavity. In this context, dental assessment should be conducted immediately after the cancer diagnosis, allowing for dental treatments to be performed prior to oncological therapy, thereby reducing the risk of oral complications during and after cancer treatment. Adverse effects, both acute and chronic, resulting from cancer treatment often manifest in the oral cavity. The most common alterations include mucositis, oral hemorrhage, dysgeusia, xerostomia, infections, salivary gland dysfunction, neuropathic pain, dental caries, osteoradionecrosis, trismus, as well as dental and craniofacial developmental anomalies. In children, the prevalence of oral manifestations is higher than in adults, significantly contributing to morbidity and, in some cases, mortality in this population. According to current guidelines, the dentist should collaborate with the oncology team to perform clinical and radiological examinations prior to the initiation of oncological treatment. This evaluation also aims to implement preventive measures and provide guidance to the patient and caregivers regarding potential oral effects of both the oncological disease and its treatment. Such care should be provided within oncology care institutions, fostering effective collaboration between the dentist and the oncology team to ensure specialized oral healthcare that contributes to improving the patient’s quality of life.
Pediatric dentistry is the branch of Dentistry concerned with the promotion, prevention, and treatment of oral health in children and adolescents. In the oncological context, “childhood cancer” refers to neoplasms diagnosed in patients under 18 years of age and represents a significant medical challenge. Cancer is a disease characterized by a high incidence rate, mortality, and poor prognosis, frequently associated with late diagnosis. The dentist plays a crucial role in the early detection of oncological diseases directly or indirectly related to the oral cavity. In this context, dental assessment should be conducted immediately after the cancer diagnosis, allowing for dental treatments to be performed prior to oncological therapy, thereby reducing the risk of oral complications during and after cancer treatment. Adverse effects, both acute and chronic, resulting from cancer treatment often manifest in the oral cavity. The most common alterations include mucositis, oral hemorrhage, dysgeusia, xerostomia, infections, salivary gland dysfunction, neuropathic pain, dental caries, osteoradionecrosis, trismus, as well as dental and craniofacial developmental anomalies. In children, the prevalence of oral manifestations is higher than in adults, significantly contributing to morbidity and, in some cases, mortality in this population. According to current guidelines, the dentist should collaborate with the oncology team to perform clinical and radiological examinations prior to the initiation of oncological treatment. This evaluation also aims to implement preventive measures and provide guidance to the patient and caregivers regarding potential oral effects of both the oncological disease and its treatment. Such care should be provided within oncology care institutions, fostering effective collaboration between the dentist and the oncology team to ensure specialized oral healthcare that contributes to improving the patient’s quality of life.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Dentista pediátrico Oncologia Manifestações orais Tratamento