Neoplasms

Blood and Lymph Conditions

All Conditions

Leukemia

Neoplasms by Histologic Type

Hematologic Diseases

Anti-Infective Agents

All Drugs and Chemicals

Dermatologic Agents

Chlorhexidine

Chlorhexidine gluconate

Patients undergo dental examination at baseline and then receive standard prevention education at diagnosis discussing the effects of prolonged neutropenia on oral hygiene, importance of a regular oral hygiene regimen, and the long term clinical outcomes of oncologic patients. Patients also receive fliers with pictograms describing proper brushing, use of mouth wash, and common oral complications during therapy, as well as a bottle and prescription for chlorhexidine gluconate 0.12% rinse.

Patients undergo dental examination and receive standard prevention education as in Group I. Patients also receive one-on-one prevention education and counseling with the physician and pediatric dental resident.

Dental Procedure

Educational Intervention (prevention education)

Interview

Survey Administration

Educational Intervention (one-on one education)

Helou A Marieka, MD, MPH

This randomized pilot clinical trial studies how well preventive education works in decreasing caries formation in pediatric patients with leukemia. Prevention education may have an effect on factors important in causing cavities in pediatric patients with leukemia.

Patients treated for leukemia at Virginia Commonwealth University Medical Center in the department of Pediatric Hematology and Oncology are currently receiving oral hygiene instruction at diagnosis. In this study, patients will be randomized into two groups at diagnosis: one receiving current prevention education and the other group receiving one-on-one prevention education and counseling with the physician and pediatric dental resident. Physician and pediatric dental resident will use motivational interviewing informed techniques during counseling. A caries risk assessment will be performed for each patient at diagnosis. Caries incidence, plaque scores, mutans streptococci levels, salivary flow rate, and salivary pH will be assessed at week one (diagnosis), week 16 or start of interim maintenance therapy whichever comes second, week 32 or beginning of maintenance therapy whichever is later for all patients enrolled in the study. Data will be collected through a clinical intraoral examination and salivary sample. Data collected will be used to assess the effect of increased prevention education on factors of importance in caries formation.

Effect of Prevention Education in Caries Formation in Pediatric Patients With Leukemia

Effect of Prevention Education on Factors of Importance in Caries Formation in Pediatric Patients With Leukemia

Change in salivary flow rate will be measured utilizing pre-weighed cotton rolls. Patients will saturate as many cotton rolls as possible in one minute by chewing. Dose cups and cotton rolls will be weighed prior to and after data collection. The change in weight in grams will be converted to mL of saliva collected.

Will be measured with litmus paper in the gingival sulcus of the tooth where plaque is collected for bacterial load testing.

Samples will be plated on mitis salivarius and incubated. Mutans streptococci colonies will be counted after incubation.

National Cancer Institute (NCI)

Virginia Commonwealth University

Infections

Symptoms and General Pathology

Communicable Diseases

Bacteremia

Sepsis

Toxemia

Bacterial Infections

Mycoses

Bacterial Infections and Mycoses

Syndrome

Systemic Inflammatory Response Syndrome

Inflammation

Rajesh V Lalla, DDS, Ph.D

Patients who are preparing to receive chemotherapy are asked to have their teeth cleaned before starting treatment as standard of care. This research study is being done to see if having dental cleaning increases the chances of bacteria from the mouth getting into the blood stream. It is also being done to see if these bacteria can cause blood stream infections in people who have a Central Venous Catheter (CVC),often called a "port" or a "PICC", placed for giving chemotherapy. It is a well-established fact that we introduce bacteria from the mouth into the bloodstream with activities of daily life including chewing, flossing and brushing teeth. This introduction of bacteria into the blood stream may cause bacteria to stick to the central venous catheter and serve as a source of infection when the immune system is weakened by cancer. The purpose of this research study is to see if we can find bacteria from mouth in blood that is drawn through the CVC, during, and after a dental cleaning procedure. This way, we will be able to assess whether or not this is a potential health risk to cancer patients.

Dental Study in Cancer Patients With Central Venous Catheters

Pilot Study on Transient Bacteremia and Blood Stream Infections After Invasive Dental Procedures in Cancer Patients With Central Venous Catheters

Blood cultures drawn before dental cleaning, 20 minutes after starting procedure, 30 minutes after finishing the procedure and at 24 hours after starting the procedure. Records reviewed at one month and six months post procedure for bloodstream or central venous catheter infection.

Rajesh Lalla

Associate Professor, School of Dental Medicine

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
Effect of Prevention Education in Caries Formation in Pediatric Patients With Leukemia	NCT03281746	Leukemia	Dental Procedur... Educational Int... Interview Survey Administ... Educational Int...	3 Years - 12 Years	Virginia Commonwealth University
Dental Study in Cancer Patients With Central Venous Catheters	NCT00798330	Cancer		18 Years -	UConn Health

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