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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
2
Undergo dental examination
Receive prevention education
Ancillary studies
Virginia Commonwealth University/Massey Cancer Center
Richmond, Virginia, United States
Change in caries assessed by CAMBRA risk assessment tool
Time frame: Baseline up to 32 weeks
Change in salivary flow rate
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.
Time frame: Baseline up to 32 weeks
Change in salivary pH
Will be measured with litmus paper in the gingival sulcus of the tooth where plaque is collected for bacterial load testing.
Time frame: Baseline up to 32 weeks
Change in levels of mutans streptococci in buccal surface of most posterior maxillary right tooth
Samples will be plated on mitis salivarius and incubated. Mutans streptococci colonies will be counted after incubation.
Time frame: Baseline up to 32 weeks
Change in caries assessed by Merged International Caries Detection and Assessment System (ICDAS)
Time frame: Baseline up to 32 weeks
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Ancillary studies
Receive one-on-one education