PurposeAlthough studies regarding dental developmental disturbances after childhood cancer treatment have increased, they have many limitations. Studies analyzing the significance of independent clinical risk factors with regard to the dental health status are also rare. We aimed to investigate the risk factors for dental developmental disturbances, particularly severe disturbances, in childhood cancer survivors (CCS).Materials and MethodsOral examinations and retrospective reviews of medical and panoramic radiographs were performed for 196 CCS (mean age, 15.6 years). Cancer type, age at diagnosis, treatment modality, type and accumulated dose of administered drugs, and dose and site of radiation were recorded. Dental developmental disturbances were diagnosed using panoramic radiographs and graded for severity according to the Modified Dental Defect Index (MDDI). Descriptive statistics and multivariate analyseswere performed to determine the association between dental abnormalities and clinical factors.ResultsIn total, 109 CCS (55.6%) exhibited at least one dental anomaly, and the median value of MDDI was 2.5. Microdontia (30.6%) was the most prevalent anomaly, followed by tooth agenesis (20.4%), V-shaped roots (14.8%), and taurodontism (10.2%). Multivariate analysis revealed that a young age at diagnosis (≤ 3 years), a history of hematopoietic stem cell transplantation, the use of multiple classes of chemotherapeutic agents (≥ 4 classes), and the use of heavy metal agents were significant risk factors for severe dental disturbances.ConclusionCCS with any of the above risk factors for severe developmental disturbances should be comprehensively followed up to minimize adverse consequences to their dental development and preserve their future dental health.

Sedation of uncooperative children for dental treatment is difficult since treatment is mainly carried out inside the oral cavity. Dexmedetomidine (DEX), recently introduced into clinical practice, has little influence on respiratory system even at high doses. We present cases of patients who underwent dental treatment under sedation using DEX infusion. DEX at a dose of 1 μg/kg was administered over 10 min after intravenous cannulation. DEX was infused to maintain sedation level within the range of the Observer's Assessment of Alertness and Sedation (OAA/S) scale 3- 4 throughout dental treatments. They were successfully treated under DEX sedation without any complications. Their uncooperative behaviors were successfully managed under DEX sedation.