Oral health and dental morbidity in long‐term allogeneic blood and marrow transplant survivors in Australia

Dyer, Gemma; Brice, Lisa; Schifter, Mark; Gilroy, Nicole; Kabir, Masura; Hertzberg, Mark; Greenwood, Matthew; Larsen, SR; Moore, John J.; Gottlieb, David; Huang, Guozhong; Hogg, Megan; Brown, Louisa; Tan, Jeff; Ward, Christopher; Kerridge, Ian

doi:10.1111/adj.12627

Cited by 14 publications

(25 citation statements)

References 45 publications

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“…In one study among HSCT recipients, patients with extensive cGVHD had on average worse QoL, compared to patients with limited or without cGVHD [34]. In another study among HSCT recipients, of which 33.3% suffered from cGVHD, a reduced QoL was found [35]. Another study reported that the QoL correlated with oral mucositis due to HSCT [36].…”

Section: Discussionmentioning

confidence: 98%

Oral health–related quality of life of patients with oral chronic graft-versus-host disease

Stolze

Boor

Hazenberg

et al. 2021

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Purpose Symptoms of oral chronic graft-versus-host-disease (cGVHD) may significantly affect the oral health–related quality of life (OHRQoL). This study aimed to assess the OHRQoL in patients with oral cGVHD and to examine whether oral cGVHD symptoms, mucosal cGVHD, and salivary gland function correlated with OHRQoL. Methods Patients referred to the oral cGVHD outpatient clinic were included. Severity of oral mucosal cGVHD, oral cGVHD symptoms, and OHRQoL was assessed by the NIH OMS, NIH OSS, and OHIP-14, respectively. Unstimulated and stimulated whole salivary flow rates were determined and categorized into “hyposalivation,” “normal salivary flow,” and “hypersalivation.” Results Of 56 included patients, 80% had mild, moderate, or severe oral mucosal cGVHD. Mean total score of OHRQoL was 16.5 (±11.7), negatively affected by functional problems. Patients reported highest scores regarding oral sensitivity and xerostomia. Significant correlations were found between severity of oral pain and OHRQoL and between oral sensitivity and OHRQoL. No correlation was found between oral mucosal cGVHD and OHRQoL. Patients with hyposalivation, normal salivary flow, and hypersalivation reported equal levels of OHRQoL. Conclusion Results demonstrate that the OHRQoL was mostly negatively affected by complaints of oral pain and oral sensitivity and less by the severity of oral mucosal cGVHD assessed by the NIH OMS score. Special attention of (oral) health care professionals for patients with oral cGVHD is mandatory to alleviate their symptoms and improve OHRQoL.

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Section: Discussionmentioning

confidence: 98%

Oral health–related quality of life of patients with oral chronic graft-versus-host disease

Stolze

Boor

Hazenberg

et al. 2021

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“…One cohort study did not report on the follow-up time (Lopez Lopez et al, 2000). The mean/median follow-up time in five cross-sectional studies ranged from 339 days to 7 years (Baker et al, 2004;Brand et al, 2009;Dyer et al, 2018;Fantozzi et al, 2020;Osiak et al, 2018). In one cross-sectional study,…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…Gross dental caries, defined as caries clinically affecting at least half of the tooth surfaces, was found in 8% of allogeneic HSCT survivors (Fantozzi et al, 2020). In cross-sectional surveys, 37% of the HSCT survivors reported dental caries (Dyer et al, 2018), and 19% reported an increased dental caries rate (Hull et al, 2012). The highest prevalence was reported in a cohort study at high risk of bias, in which 43% of the HSCT recipients showed caries 3 months after transplantation, in accordance with the proportion of patients displaying caries before HSCT (Barrach et al, 2015).…”

Section: Dental Cariesmentioning

confidence: 99%

Caries, periodontitis and tooth loss after haematopoietic stem cell transplantation: A systematic review

Gennip¹,

Bulthuis²,

Blijlevens³

et al. 2022

Oral Diseases

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ObjectiveA systematic review was conducted to assess scientific knowledge concerning the effect of haematopoietic stem cell transplantation (HSCT) on the occurrence of caries, periodontal conditions and tooth loss, and to evaluate the prevalence of these diseases in adult HSCT survivors (PROSPERO 152906).MethodsPubMed and Embase were searched for papers, published from January 2000 until November 2020 without language restriction, assessing prevalence, incidence or parameters of caries, periodontal conditions and tooth loss in HSCT recipients (≥80% transplanted in adulthood). Bias risk was assessed with checklists from Joanna Briggs Institute, and data synthesis was performed by narrative summary.ResultsEighteen papers were included (1618 subjects). Half were considered at high risk of bias. Longitudinal studies did not show caries progression, decline in periodontal health or tooth loss after HSCT. The prevalence in HSCT survivors ranged from 19% to 43% for caries, 11% to 67% for periodontitis, and 2% to 5% for edentulism. Certainty in the body of evidence was very low.ConclusionsHaematopoietic stem cell transplantation, on the short term, may have little to no effect on caries, periodontal conditions and tooth loss. Caries and periodontitis may be more common in HSCT survivors compared with the general population, whereas edentulism may be comparable. However, the evidence for all conclusions is very uncertain.

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“…Tooth decay, or dental caries, is a common finding in survivors of HSCT [Elad et al, 2015]. A high caries prevalence was reported in patients who had undergone allogeneic HSCT 1-14 years previously, in comparison with the general population [Dyer et al, 2018]. HSCT recipients may already be at higher caries risk before the treatment, as patients planned for HSCT were reported to have higher number of decayed, missing, and filled teeth (DMFT), compared with the general population [Mauramo et al, 2019] or with healthy controls [Uutela et al, 2019b[Uutela et al, , 2020.…”

Section: Introductionmentioning

confidence: 99%

Caries Progression after Haematopoietic Stem Cell Transplantation and the Role of Hyposalivation

Bulthuis¹,

Gennip²,

Thomas³

et al. 2022

Caries Res

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Haematopoietic stem cell transplantation (HSCT) preceded by a conditioning regimen is an established treatment option for many haematological diseases. Decreased salivary flow rates after HSCT may increase caries risk. We aim to estimate the extent to which caries lesions develop or progress in adult HSCT recipients and assess its association with salivary flow rate. A multi-centre prospective observational study was conducted in which patients receiving HSCT were followed up for 18 months. We included 116 patients (median age 56 years, 43% female) from two medical centres in the Netherlands. Unstimulated (UWS) and stimulated (SWS) whole saliva was collected and full caries charts were made before HSCT and 3, 6, 12 and 18 months post-HSCT. Caries was scored according to the ICDAS criteria by trained dentist-examiners. New dentine lesions or lesion progression into dentine (ICDAS ≥4 or cavitated root lesions) occurred in 32% of patients over 18 months. The median number of affected surfaces was 2 (range: 1 – 12) per patient with caries progression. The influence of hyposalivation of unstimulated saliva (<0.2 mL/min) and stimulated saliva (<0.7 mL/min) at baseline and after 3 months on caries progression was determined with a negative binomial regression model. Hyposalivation of SWS 3 months after HSCT was a significant risk indicator for caries progression (incidence rate ratio: 5.30, 95% CI: 2.09 – 13.4, p < 0.001), while hyposalivation of SWS at baseline and hyposalivation of UWS were not. We conclude that caries progression is a common oral complication in patients after HSCT, and stimulated hyposalivation shortly after treatment is a significant risk indicator for caries progression.

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Oral health and dental morbidity in long‐term allogeneic blood and marrow transplant survivors in Australia

Cited by 14 publications

References 45 publications

Oral health–related quality of life of patients with oral chronic graft-versus-host disease

Oral health–related quality of life of patients with oral chronic graft-versus-host disease

Caries, periodontitis and tooth loss after haematopoietic stem cell transplantation: A systematic review

Caries Progression after Haematopoietic Stem Cell Transplantation and the Role of Hyposalivation

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