Long-Term Effects of Childhood Cancer Treatment on Dentition and Oral Health: A Dentist Survey Study from the DCCSS LATER 2 Study

Abstract

Objectives: The aim of this study was to identify the prevalence of and independent risk factors for long-term effects of childhood cancer treatment on the dentition and oral health in childhood cancer survivors (CCSs). Methods: This cross-sectional study is part of the Dutch Childhood Cancer Survivor Study (DCCSS) LATER 2. CCSs were diagnosed with cancer between 1963 and 2001. This study focuses on survey data of 154 CCSs on whom information about their oral health was received from their dentists (71.3%). Descriptive statistics and univariable and multivariable Poisson regression analyses were performed to determine the association between treatment characteristics and oral health data. Results: Of the study group, 36.3% had at least one DDD. The most prevalent DDDs were short-root anomaly (14.6%), agenesis (14.3%), and microdontia (13.6%). Risk factors for at least one DDD were younger age at diagnosis (<3 years) and dose-dependent alkylating agent therapy. Conclusions: This study provides more insight into risk factors for oral health problems in Dutch CCSs. This information is essential in order to improve early detection, prevention, dental care, and quality of life. Further studies are needed in order to better define dose-related radiotherapy exposure of the developing teeth in correlation with oral health problems.

Oral and dental late effects in long-term survivors of childhood embryonal brain tumors

“…Since most survivors in our study were treated with the combination of CSI and chemotherapy, it is difficult to evaluate the independent impact of different treatment modalities on dental development [6]. Several previous studies reported that vincristine and alkylating substances such as cyclophosphamide may be associated with DDD in childhood cancer survivors [6,11,41,42]. In contrast, in a recent published study no association between DDD and specific type of chemotherapy agent was reported [40].…”

Oligomicrodontia in a Pediatric Cancer Survivor after Chemotherapy: A Case Report

“…Development disturbances can be influenced by genetic, epigenetics, and environmental factors, such as chemotherapy, radiotherapy, and chemoradiotherapy treatment at an early age. Various studies reported effects on craniofacial and dental development caused by chemotherapy administered during the stages of tooth development [ 4 , 6 , 10 , 13 , 14 , 15 ].…”

“…In the study, Stolze et al found a significantly increased risk of one or more dental development disorders in pediatric cancer survivors younger than 3 years old treated with chemotherapy compared with older children as well with the dose exposure of alkylating agent. The dose of >4 g/m 2 significantly increased the risk of developing ≥ 1 dental abnormalities [ 10 ]. An eight times greater risk of developing dental abnormalities was reported by Seremedi et al in patients who received high doses of cyclophosphamide, >4 g/m 2 [ 28 ].…”

“…An eight times greater risk of developing dental abnormalities was reported by Seremedi et al in patients who received high doses of cyclophosphamide, >4 g/m 2 [ 28 ]. Likewise, it showed a significant association of topoisomerase 2 inhibitors (etoposide) with one dental development disorder using univariable analysis, while no association with risk was obtained using Poisson analysis [ 10 ]. Another commonly used chemotherapeutic agent, vincristine, has been identified as a cause of tooth abnormalities by interfering with the calcium transport mechanism and secretory function of ameloblasts [ 33 ].…”

“…Effects of chemotherapy on dental development may vary, depending on the time concurrent developmental phase which was affected. Dental development anomalies include arrested root development, taurodontism, microdontia, hypodontia, and enamel defects, while tooth eruption seems to be delayed [ 4 , 5 , 6 , 10 ].…”