Dental health of childhood cancer survivors – a report from the Swiss Childhood Cancer Survivor Study (SCCSS)

Abstract

Background: Cancer and its treatments can affect dental health of childhood cancer survivors. We aimed to evaluate prevalence of dental problems in survivors, compare them to their siblings, and investigate cancer-related risk factors. Methods: As part of the population-based Swiss Childhood Cancer Survivors Study, we sent questionnaires inquiring about dental problems to survivors aged 5-19 years and their siblings. We retrieved cancer-relevant information from the Swiss Childhood Cancer Registry and used logistic regressions to compare dental problems between survivors and siblings and to investigate cancer-related risk factors. Results: We included 735 survivors and 144 siblings. Almost half of survivors and siblings reported at least one dental problem. Compared to siblings, survivors had a greater risk for hypo- or microdontia (OR 1.7; 95%CI 0.9-3.2) and enamel hypoplasia (2.2; 0.8-6.0), but similar risk for cavities or cavity-related tooth loss (0.8; 0.6-1.3). Chemotherapy was associated with enamel hypoplasia (3.0; 1.2-10.4), cavities or cavity-related tooth loss (1.5; 1.0-2.3), and gum problems during (23.0; 9.4-76.2) and after (4.6; 2.0-13.5) treatment. Hematopoietic stem cell transplantation (HSCT) was related to hypo- or microdontia (5.4; 2.6-10.7), cavities or cavity-related tooth loss (2.1; 1.2-3.6), and gum problems during treatment (2.0; 1.2-3.6). For hypo- or microdontia and cavities, associations with treatment were driven by patients diagnosed <5 years. Conclusion: Childhood cancer patients treated with chemotherapy or HSCT, especially at a young age, were at higher risk for dental problems. Regular dental check-ups guided by healthcare teams and dental hygiene habits can mitigate risks and promote long-term dental health of survivors.