Date of Award

5-2022

Degree Type

Thesis

Degree Name

MS in Epidemiology & Biostatistics

First Advisor

Dr Uzma Shamsi

Second Advisor

Dr Farhan Raza Khan

Third Advisor

Dr Yasmin Rashid

Department

Community Health Sciences

Abstract

Introduction: Oral mucositis (OM) is an inflammatory condition of oral cavity which is a common but serious side effect of cancer treatment. It is usually observed within 3-5 days after the first cycle of chemotherapy and reaches its peak intensity at 7-14 days. Severe OM compromises basic functions like eating and swallowing causing malnutrition. This could lead to changes in social engagement and emotional wellbeing affecting the overall oral health related quality of life (OHRQOL). The aim of the study was to find the frequency of OM amongst breast cancer (BC) patients during chemotherapy, the factors associated with it and the overall patient’s Oral Health Related Quality of Life (OHRQoL).
Methods: A cross-sectional study was conducted and a total of 160 women diagnosed with BC, receiving chemotherapy and who had undergone at least one cycle of chemotherapy were recruited from Aga Khan University Hospital (AKUH) & Jinnah Post Graduate Medical Center (JPMC).In-person interviews were done, patients were asked questions about their sociodemographic history, personal habits, oral history and oral findings, breast cancer stage , chemotherapy history and Oral Health Related Quality of Life (OHRQoL).Their oral examination was done at the end of the interview to assess presence or absence of OM, using World Health Organization (WHO) OM tool. OHRQoL was assessed using Oral Health Impact Profile (OHIP)-14 questionnaire.
Results: Our results showed that out of 160 patients 88 (55%) of the BC cases developed OM during chemotherapy. The mean OHIP-14 scores in patients with OM was high (18.36+0.96) showing poor OHRQOL. Occasional frequency of brushing was significantly associated with OM (Prevalence ratio:2.26, 95%_CI 1.06 - 4.84) compared to those patients who brushed once and twice daily. Low level of education showed negative association with OM (Prevalence ratio:0.52, 95%_CI 0.31 -0.88). Oral care provided by doctors/nurses during chemotherapy was not found to be associated with the risk of OM (Prevalence ratio:1.11, 95%_CI 0.66 - 1.87)
Conclusion: Our study showed significant positive association of occasional brushing with OM and negative association of low level of education with the development of OM. Emphasis should be given to oral hygiene instructions and dental education to cancer patients in oncology clinics with the prescription of mouth washes, gels and analgesics to patients to decrease OM during chemotherapy.

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1

Last Page

93

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