Dental management of a child undergoing treatment for Wilms’ tumor: A Case Report.

Abstract

Introduction: Wilms’ Tumor is a malignant renal neoplasm that frequently occurs in children during the first decade of life. Clinically, it is a rapidly growing abdominal mass that causes low back pain and hematuria. Computerized axial tomography or nuclear magnetic resonance are fundamental for its diagnosis, and chemotherapy and surgery have become first-choice treatments. After diagnosis, the majority of treatment plans involve the administration of antineoplastic drugs, whose side effects may include mucositis, candidiasis, xerostomia, caries, and worsen other previously diagnosed lesions, regardless of the organ affected by the tumor. Treatment is more effective if provided by a multidisciplinary team in which the dentist plays a significant role in the implementation of an integral oral care protocol. In the present study, the management of a pediatric patient under antineoplastic treatment for Wilms’ tumor is reported. Case report: A four-year-old female patient diagnosed with Wilms' tumor, who required antineoplastic treatment. She had temporary dentition with early childhood caries, irreversible pulpal lesions and agenesis of teeth 72, 82, and the germ of tooth 42. The patient received modeling based behavior management therapy, prophylactic oral hygiene, and restoration of teeth affected by caries. To present this case, the "CARE" guidelines were used. Conclusion: Poor oral health status prior to cancer therapy directly affects the quality of life and the treatment of a patient, increasing the risks of local or systemic infections. As such evaluation and dental treatment before antineoplastic therapy is important to prevent oral complications and lesions.