Management of xerostomia using chlorine dioxide mouthwash in post-surgical and chemotherapy breast cancer patient with aromatase inhibitor treatment (anastrazole)

Ronden Perwiradinata(1), Desiana Radithia(2), Adiastuti Endah(3), Bagus Soebadi(4),


(1) Department of Oral Medicine, Faculty of Dental Medicine, Airlangga Universit, Surabaya, Indonesia
(2) Department of Oral Medicine, Faculty of Dental Medicine, Airlangga Universit, Surabaya, Indonesia
(3) Department of Oral Medicine, Faculty of Dental Medicine, Airlangga Universit, Surabaya, Indonesia
(4) Department of Oral Medicine, Faculty of Dental Medicine, Airlangga Universit, Surabaya, Indonesia

Abstract

Objective: A 59-year-old woman with complaints of dry mouth, often feel thirsty, pain when swallowing, chapped lips, bleeding gums and bad breath. The patient had a history of breast cancer, underwent surgery and chemotherapy in 2010. The patient consumed 1 mg of Aromatase Inhibitors (AIs) tablets a day for 9 years.

Methods: Patient underwent depression, anxiety and Stress Scale (DASS) questionnaire (Depression: normal; Anxiety: mild; and Stress: mild) and sialometry test (draining method) <0.1 ml/minute. Patient was diagnosed with xerostomia then instructed to use chlorine dioxide mouthwash 4 times a day. Management included anamnesis, clinical and laboratory examination: Complete Blood Count (CBC); Diabetic Profile; Lipid Profile; Renal Function Profile; and Tumour Marker test.

Results: Patient’s sialometry test results in 1st, 2nd, 3rd and 4th visit are: 0.1ml/minute; 0.6ml/minute; 1.4ml/minute and 1.8ml/minute.

Conclusion: Dentist has important role to evaluate and treat oral condition for optimal and comprehensive breast cancer treatment. Chlorine dioxide mouthwash is clinically proven to stimulate salivary gland in treating xerostomia.

Keywords

Aromatase inhibitor, Breast Neoplasms, Chlorine dioxide mouthwash, Xerostomia

Full Text:

PDF

References

Nugraha AP, Ernawati DS, Harijanti K, et al. Psychological Stress Induced Xerostomia and Hyposalivation: the case study in Indonesian female patient. J Int Dent Med Res 2019;12: 216-219.

Jensen SB, Pedersen AML, Vissink A, et al. A systematic review of salivary gland hypofunction and xerostomia induced by cancer therapies: prevalence, severity and impact on quality of life. Support Care Cancer 2010;18: 1039-1060.

Sreebny LM, Vissink A. Dry mouth: the malevolent symptom: a clinical guide. 1st ed. New Jersey: John Wiley & Sons; 2010. p. 98-103.

Piñeyro-de SOST, Munerato MC. Burning mouth syndrome-latest update. Int J Dentist Res 2016;1: 14-23.

Coculescu EC, Radu A, Coculescu BI. Burning mouth syndrome: a review on diagnosis and treatment. J Med Life 2014;7: 512-515.

Spanemberg JC, Campillo ERR, Salas EJ, et al. Burning mouth syndrome: update. OHDM 2014;13: 418-424.

Tu TTH, Takenoshita M, Matsuoka H, et al. Current management strategies for the pain of elderly patients with burning mouth syndrome: a critical review. BioPsychoSoc Med 2019;13: 1-9.

Lecor PA, Ndiaye ML, Guirassy ML, et al. “Burning mouth syndrome: pathophysiology, investigations and management- a review”. Acta Sci Dent Sci 2018;2: 26-32.

Lima ENA, Barbosa NG, Santos ACS, et al. Comparative analysis of psychological, hormonal, and genetic factors between burning mouth syndrome and secondary oral burning pain. Med 2016;17: 1602-1611.

Minguez-Sanz MP, Salort-Llorca C, Silvestre-Donat FJ. Etiology of burning mouth syndrome: A review and update. Med Oral Patol Oral Cir Bucal 2011;16: 144-148.

Cuzick J, Sestak I, Forbes JF, et al. Anastrozole for prevention of breast cancer in high-risk postmenopausal women (IBIS-II): an international, double-blind, randomised placebo-controlled trial. Lancet 2014;383: 1041-1048.

Mouridsen HT, Lønning P, Beckmann MW, et al. Use of aromatase inhibitors and bisphosphonates as an anticancer therapy in postmenopausal breast cancer. Expert Rev. Anticancer Ther 2010;10: 1825-1836.

Barros-Oliveira MC, Costa-Silva DR, Benigno de Andrade D, et al. Use of anastrozole in the chemoprevention and treatment of breast cancer: a literature review. Rev Assoc Med Bras 2017;63: 371-378.

Muddugangadhar BC, Sangur R, Rudraprasad IV, et al. A clinical study to compare between resting and stimulated whole salivary flow rate and pH before and after complete denture placement in different age groups. J Indian Prostho Soc 2015;15: 356-366.

Saleh TM, Connell BJ. Role of oestrogen in the central regulation of autonomic function. Clin Experiment Pharmacol Physiol 2007;34: 827-832.

Bilge NSY, Korkmazb C. Does Aromatase Inhibitors Cause Sjogren’s Syndrome and Polyneuropathy? World J Oncol 2014;5: 181-182.

Vigano L, Cinzia C, Oliveira A, et al. Breast cancer and its treatment: impact on oral health. a traditional review. Acta Scientific Microbiol 2018;1: 44-50.

Taichman LS, Havens AM, Poznak CH. Potential implications of adjuvant endocrine therapy for the oral health of postmenopausal women with breast cancer. Breast Cancer Res Treat 2013;137: 23-32.

Taichman LS, Gomez G, Inglehart MR. Oral health-related complications of breast cancer treatment: assessing dental hygienists’ knowledge and professional practice. J Dent Hygiene 2014;88: 22-37.

Siregar MFG. Menopause and the oral cavity: an oral hygiene update in Indonesia. Int J Community Med Public Health 2015;2: 210-216.

Epstein JB, Thariat J, Bensadoun RJ, et al. Oral complications of cancer and cancer therapy. from cancer treatment to survivorship. CA Cancer J Clin 2012;62: 401-422.

Lakoski SG, Jones LW, Krone RJ, et al. Autonomic dysfunction in early breast cancer: Incidence, clinical importance, and underlying mechanisms. American Heart J 2015;170: 231-241.

Won E, Kim Y. Stress, the Autonomic Nervous System, and the Immune-kynurenine Pathway in the Etiology of Depression. Current Neuropharmacol 2016;14: 665-673.

Akiyoshi M, Kato K, Owa Y, et al. Relationship between estrogen, vasomotor symptoms, and heart rate variability in climacteric women. J Med Dent Sci 2011;58: 49-59.

Venkatasatya SRM, Wang HH, Alluri S, et al. Phosphate buffer-stabilized 0.1% chlorine dioxide oral rinse for managing medication-related osteonecrosis of the jaw. American J Dentist 2017;30: 350-352.

Saini R. Chlorine dioxide: An ideal preprocedural mouthrinse in dental set-up. Europ J General Dentist 2015;4: 113-116.

Dimension

Altmetric

PlumX


DOI:
https://doi.org/10.20956/jcrdm.v2i1.107

Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License. View My Stats