Oral cavity health and dental health behavior among pediatric cancer patients after discharge

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退院後の小児がん患者の口腔の健康状態と歯科保健行動の問題点を明らかにし，小児がん患者の歯科保健指導のあり方を検討することを目的とした．Ａ市内の総合病院2施設で小児がん治療を受けて退院した小児と保護者66名を対象に，構造化面接法による口腔の健康状態と歯科保健行動に関する質問紙調査を実施した．口腔の健康状態では，「う蝕歯あり」は47名（71.2%），「う蝕5本以上」17名（25.8%）であった．治療内容別に比較した結果，造血幹細胞移植実施群（p <0.05）と放射線療法実施群（p <0.01）において「う蝕5本以上」の割合が高かった．造血幹細胞移植群では化学療法開始年齢が3歳未満において「う蝕5本以上」の割合が高かった（p <0.05）．形成障害については，造血幹細胞移植実施群，放射線療法実施群での割合が高かった（p <0.01）．造血幹細胞移植実施群では，化学療法開始年齢3歳未満が「矮小歯・先天性欠如あり」の割合が高かった（p <0.05）．歯科保健行動については，9割以上が1日2回以上歯磨きを実施していたが，歯科定期受診しているものは3割以下であった．退院後の小児がん患者の口腔の健康状態は，う蝕や形成障害などの問題が多いが歯科の定期受診の割合が低いことから，歯科の晩期合併症に対する情報を提供し，定期的な歯科受診の必要性について指導する必要がある． This study aimed to clarify the state of oral cavity health and the dental health behavior among pediatric cancer patients after they are discharged from a hospital environment. We obtained consent to participate from 66 subjects comprising children who had been treated for pediatric cancer at and discharged from two general hospitals in City A and their parents, and structured interviews. Among the respondents, 47 (71.2%) reported that the children had dental caries and 17 (25.8%) reported that the dental caries affected five or more teeth. The incidence was high among those who had undergone hematopoietic stem cell transplantation (p<0.05) and those who had undergone radiation therapy (p<0.01). Among children who had undergone hematopoietic stem cell transplantation, the incidence was high in children who were younger than 3 years old when they began undergoing treatment (p<0.05). For dysplasia, the incidence was high for children who had undergone hematopoietic stem cell transplantation and those who had undergone radiation therapy (p<0.01). Among children who had undergone hematopoietic stem cell transplantation, there was a high incidence of microdontia or congenital lack of teeth for children who were younger than 3 years old when they began chemotherapy (p<0.05). Over 90% of the children were currently brushing their teeth twice a day. Approximately 70% of the children had been told the name of their illness, and fewer than 30% were receiving regular dental checkups. It is important to ensure that patients and parents are provided with information about late dental complications and emphasize the necessity for regular dental checkups. It is necessary to provide guidance on the need for dentist consultation for about late effects.

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