Chemo or Radiation at Young Age May Negatively Impact Oral Health, Study Finds

South Korea: A new study suggests that age at initial chemotherapy is a critical factor in the dental developmental complications following paediatric hematopoietic stem cell transplantation.

The study, published in the Journal of Clinical Medicine, aimed to investigate the prevalence and extent of dental developmental complications in patients who have undergone paediatric hematopoietic stem cell transplantation (SCT) and identify the risk factors.

Materials and Methods

Led by Professors Kim Yoon-ji and Chung Nack-Gyun, the researchers retrospectively investigated the clinical data warehouse of the Catholic Medical Center information system for identifying patients who visited the Department of Pediatrics between 2009 and 2019, underwent SCT under the age of 10, and had panoramic radiographs.

Thus, 153 patients were included in this study. The prevalence and extent of tooth agenesis, microdontia, and root malformation were assessed using panoramic radiographs obtained after SCT, and the risk factors were analyzed using regression analysis.

Prevalence of Agenesis Highest in the Youngest Age Group

The study found that all 153 patients had at least one dental anomaly. When grouped according to the age at initial chemotherapy (≤ 2.5; 2.6–5.0; 5.1–7.5; > 7.5 years), the prevalence of agenesis showed statistically significant differences among the different age groups (P < 0.001).

The prevalence of agenesis was highest in the youngest age group. As the initial age at chemotherapy increased, the number of affected teeth per patient decreased for all three anomalies.

The location of the affected tooth was also influenced by the age at initial chemotherapy. Regression analysis demonstrated that young age at initial chemotherapy was a risk-increasing factor for tooth agenesis and microdontia.

The study concluded that the age at initial chemotherapy may be a critical factor in determining the type, extent, and location of dental complications after SCT. These results suggest that careful dental follow-up and timely treatment are recommended for pediatric patients undergoing SCT.

Importance of Dental Follow-up and Timely Treatment

The study highlights the importance of dental follow-up and timely treatment for pediatric patients undergoing hematopoietic SCT. Disturbances in dental development have been reported after undergoing hematopoietic SCT combined with chemotherapy and/or radiotherapy.

Previous studies have mainly focused on the long-term effects of chemotherapy and treatment modalities such as specific chemotherapeutic agents and TBI. However, the current study suggests that the timing of anti-cancer treatment and/or the treatment regimen may also play a critical role in the development of dental complications.

Further studies are needed to confirm the findings of this study and to develop appropriate preventive and treatment strategies for dental developmental complications in paediatric patients undergoing SCT.

Read the article: Dental developmental complications in pediatric hematopoietic stem cell transplantation patients: A study using CMC clinical data warehouse.