Long term oral and dental effects in adolescents who were treated for
cancer in childhood
Abstract
Background: Survival following childhood cancer has increased
considerably. We examined associations of specific types of cancer
therapy with the presence of oral and dental abnormalities among
childhood cancer survivors. Procedure: 131 children who were diagnosed
with malignancies during childhood were referred to full oro-dental
exams. Permanent teeth were examined clinically and radiographically to
identify dental caries and anomalies in dental developmental:
hypocalcification or hypoplasia, microdontia, root changes and absent
tooth bud categorized hypodontia. Results: Dental developmental
anomalies were observed in 56 (46%) of 121 children, in 309 teeth
(9%). Hypocalcification or hypoplasia of enamel appeared in 21 (17%)
patients. The mean decayed, missing and filled teeth (DMFT) score was
6.69 (SD 6.19). Altered root development appeared in 26 patients and
hypodontia affected 13 (10%). Dental anomalies were observed in 36
(43%) individuals who received chemotherapy and not radiation, in 20
(52.63%) who received radiotherapy, and in 15 (60%) of those who
received head & neck radiotherapy. Young age (under 6 years) was
associated with a higher number of malformed teeth among patients who
received only chemotherapy. Various chemotherapy agents associated
similarly with dental anomalies and also with DMFT. Conclusions:
Antineoplastic treatment that combines chemotherapy and radiotherapy
appears to increase the risk of developing serious dental anomalies.
Radiation to the head and neck area particularly increases the risk of
dental developmental anomaly. No specific chemotherapy agent was found
to be associated more than the others with dental side effects.