Dental abnormalities in children preparing for pediatric bone marrow transplantation

Abstract

Summary:The purpose of our study was to describe the types and frequencies of altered dental development in pediatric patients preparing for bone marrow transplantation (BMT). Retrospective review of the medical records and panoramic radiographs of all patients who underwent BMT at St Jude Children's Research Hospital between 1990 and 2000 for whom pre-BMT dental examination and panoramic radiography records were available. All patients were treated on institutional protocols. We recorded patient demographics and radiographic evidence of microdontia, hypodontia, taurodontia, root stunting, caries, enamel pearls, and pulpal calcifications. The 259 patients identified (150 male and 109 female) had a median age of 12.82 years (range, 3.18-25.93 years) at the time of BMT. In total, 203 were Caucasian, 38 were African-American, and 18 were of other races. In all, 150 (57.9%) had abnormal dentition. The most common dental abnormalities were caries (n ¼ 84), pulpal calcifications (n ¼ 34), and dental extractions (n ¼ 33). Developmental abnormalities occurred less frequently: taurodontia (n ¼ 8), hypodontia (n ¼ 10), microdontia (n ¼ 11), and root stunting (n ¼ 11). Dental abnormalities are prevalent in children undergoing BMT. Pre-transplant oral hygiene and dental examination should be standard care in order to minimize potential sites of infection.

Microdontia after chemotherapy in a child treated for neuroblastoma

“…The prevalence of microdontia is generally very low. A recent study on children preparing for bone marrow transplantation reported only 4% microdontia (17). On the other hand, very high prevalence of microdontia (78%) was shown in a group of patients with high‐risk neuroblastoma treated with autologous stem cell transplantation after myeloablative therapy with high‐dose chemotherapy and/or total body irradiation (10).…”

Oral Mucositis in Children Suffering from Acute Lymphoblastic Leukaemia”

“…The authors, who had observed poor oral hygiene in children prior to bone marrow transplantation, included the patients in routine dental care in order to minimise the occurrence of complications and infections in the oral cavity. The procedure included teaching the children to brush their teeth and to clean them with dental floss, as well as fluoride varnish (16,17) .…”

County-level determinants of dental utilization for Medicaid-enrolled children with chronic conditions: How does place affect use?

“…Second, children are able to benefit directly from diagnostic and preventive treatment (e.g., radiographs, examinations, pit and fissure sealants, topical fluoride treatments) as well as restorative care when disease is already present (American Academy of Pediatric Dentistry, 2011). Dental care can help improve health outcomes in children with chronic conditions such as leukemia and other malignancies during bone marrow transplant treatment (Vaughan et al, 2005) by preventing systemic infections. Another example relates to children with orofacial conditions, many of whom require multiple dental and medical surgical interventions.…”