Prevalence and Risk Factors for Hyposalivation and Xerostomia in Childhood Cancer Survivors Following Different Treatment Modalities—A Dutch Childhood Cancer Survivor Study Late Effects 2 Clinical Study (DCCSS LATER 2)

Abstract

Background: Limited data are available on the risk factors of salivary gland dysfunction in long-term childhood cancer survivors (CCS). The objective of this cross-sectional study, part of the multidisciplinary multicenter Dutch CCS Study Late Effects 2 (DCCSS LATER 2), was to assess the prevalence of and risk factors for hyposalivation and xerostomia in CCS. Methods: From February 2016 until March 2020, 292 CCS were included. Data with regard to gender, age at study, diagnosis, age at diagnosis, and treatment characteristics were collected, as well as the unstimulated (UWS) and stimulated whole salivary flow rate (SWS). Xerostomia was assessed with the Xerostomia Inventory (XI) questionnaire. Multivariable Poisson regression analyses were used to evaluate the association between potential risk factors and the occurrence of hyposalivation. Results: The minimum time between diagnosis and study enrollment was 15 years. The prevalence of hyposalivation was 32% and the prevalence of xerostomia was 9.4%. Hyposalivation and xerostomia were not significantly correlated. Risk factors for hyposalivation were female gender and a higher dose of radiotherapy (>12 Gy) to the salivary gland region. Conclusion: Considering the importance of saliva for oral health, screening for hyposalivation in CCS is suggested in order to provide optimal oral supportive care aimed to improve oral health.

Self-reported outcomes on oral health and oral health-related quality of life in long-term childhood cancer survivors—A DCCSS-LATER 2 Study

“…For the detection of dry mouth, we saw a similar trend. In 4.0% of CCS, dentists reported that complaints of xerostomia were present [ 6 ], while 9.4% of CCS experienced xerostomia [ 7 ].…”

“…The SALI subproject selected CCS who had received head and neck radiotherapy (H&N RT) or total body irradiation (TBI), and CCS who had not. The inclusion procedure for the SALI subproject has previously been described in detail [ 7 ].…”

“…Among CCS, oral late effects are prevalent [ 3 – 5 ]. Recently, we published two cross-sectional articles on dental developmental disorders, oral health problems, hyposalivation and xerostomia among CCS with a follow-up time of more than 15 years [ 6 , 7 ]. Of the included CCS, 36.1% experienced at least one dental developmental disorder, 20.4% had increased caries susceptibility, 32.0% had objectively measured hyposalivation and 9.4% experienced xerostomia, the sensation of dry mouth [ 6 , 7 ].…”

“…Recently, we published two cross-sectional articles on dental developmental disorders, oral health problems, hyposalivation and xerostomia among CCS with a follow-up time of more than 15 years [ 6 , 7 ]. Of the included CCS, 36.1% experienced at least one dental developmental disorder, 20.4% had increased caries susceptibility, 32.0% had objectively measured hyposalivation and 9.4% experienced xerostomia, the sensation of dry mouth [ 6 , 7 ]. These long-term effects could affect the oral health-related quality of life (OHRQoL), which represents the quality of life (QoL) in relation to perceived oral health.…”

Reduced Salivary Flow Rate and Increased Caries Susceptibility in Italian Children in Remission from Hematological Malignancy

“…Conversely, other studies failed to demonstrate any adverse effect of CT on salivary glands in the early stage of cancer treatment [18][19][20]. Long-term data are scarce [21,22], and most of them focused on hematopoietic stem cell transplantation (HSCT) recipients [23,24]. Reduced salivary flow has been observed even 5 to 15 years after CT [21,22].…”