Oral and dental late effects in survivors of childhood cancer: a Children’s Oncology Group report

Abstract

Purpose Multi-modality therapy has resulted in improved survival for childhood malignancies. The Children’s Oncology Group Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancers provide practitioners with exposure- and risk-based recommendations for the surveillance and management of asymptomatic survivors who are at least 2 years from completion of therapy. This review outlines the pathophysiology and risks for oral and dental late effects in pediatric cancer survivors and the rationale for oral and dental screening recommended by the Children’s Oncology Group. Methods An English literature search for oral and dental complications of childhood cancer treatment was undertaken via MEDLINE and encompassed January 1975 to January 2013. Proposed guideline content based on the literature review was approved by a multi-disciplinary panel of survivorship experts and scored according to a modified version of the National Comprehensive Cancer Network “Categories of Consensus” system. Results The Children’s Oncology Group oral-dental pan el selected 85 relevant citations. Childhood cancer therapy may impact tooth development, salivary function, craniofacial development, and temporomandibular joint function placing some childhood cancer survivors at an increased risk for poor oral and dental health. Addition ally, head and neck radiation and hematopoietic stem cell transplantation increase the risk of subsequent ma lignant neoplasms in the oral cavity. Survivors require routine dental care to evaluate for potential side effects and initiate early treatment. Conclusions Certain childhood cancer survivors are at an increased risk for poor oral and dental health. Early identification of oral and dental morbidity and early interventions can optimize health and quality of life.

Effects of oncological treatment on tooth development in children with brain tumors: Description of cases

“…6,7 Dysfunction of salivary glands, followed by xerostomia, may lead to increased susceptibility to oral infections, sleep disturbances and difficulties in eating or even speaking. In long term prospects, decreased salivary flow can lead to enamel demineralization and increased caries.…”

Parental Attitudes of Dental Care in Childhood Cancer

“…Bu nedenle kemoterapi ve radyoterapi uygulaması süresince dental tedavilerin yapılması, hem dental komplikasyonların önlenebilmesi, hem de tedavi protokolünün aksamaması için oldukça önemlidir. [13][14][15][16][17] Aynı şekilde ailelere dental gelişimin uzun dönemde de etkilenebileceği, ortodontik problemler ortaya çıkabileceği belirtilmelidir. [18][19][20][21] Bu amaçla çocukluk çağı kanser teşhisi konulduğu andan itibaren çocukların diş hekimine düzenli kontrol için gitmeleri konusunda aileler teşvik edilmelidir.…”

Late effects in children who underwent hematopoietic stem cell transplantation (review)

“…При миелоаблативных режимах (и в особенности при включении в кондиционирование облучения) может страдать ротовая полость [52]. Кроме того, не-обходимо принимать во внимание и факторы, пред-шествующие лечению основного заболевания, незре-лость у пациентов с первичными иммунодефицитами, предрасположенность к дефектам слизистых у паци-ентов с анемией Фанкони, дефекты развития зубов у пациентов с МПС.…”

“…Кроме того, не-обходимо принимать во внимание и факторы, пред-шествующие лечению основного заболевания, незре-лость у пациентов с первичными иммунодефицитами, предрасположенность к дефектам слизистых у паци-ентов с анемией Фанкони, дефекты развития зубов у пациентов с МПС. Наиболее часто возникают изме-нение зубов и ксеростомия [52,53].…”