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Impact of radiation and chemotherapy on risk of dental abnormalities
Cancer, 10/20/09

Kaste SC et al. – The current study was performed to describe frequencies and risk factors of altered oral health and odontogenesis in childhood cancer survivors. Radiation and chemotherapy were independent risk factors for adverse oral-dental sequelae among childhood cancer survivors. The authors concluded that patients who received receiving alkylating agents at age <5 years should be closely monitored. p> Methods

9308 survivors
Diagnosed between 1970 and 1986 and 2951 siblings from Childhood Cancer Survivor Study completed survey that contained oral-dental health information
Analyzed treatment impact, socioeconomic data, and patient demographics on dental outcomes using univariate and multivariate logistic regression models to estimate odds ratios

Results

In multivariate analysis, survivors more likely to report microdontia (OR, 3.0; 95% confidence interval [95% CI], 2.4-3.8), hypodontia (OR, 1.7; 95% CI, 1.4-2.0), root abnormalities (OR, 3.0; 95% CI, 2.2-4.0), abnormal enamel (OR, 2.4; 95% CI, 2.0-2.9), teeth loss ≥ 6 (OR, 2.6; 95% CI, 1.9-3.6), severe gingivitis (OR, 1.2; 95% CI, 1.0-1.5), and xerostomia (OR, 9.7; 95% CI, 4.8-19.7)
Controlling for chemotherapy and socioeconomic factors, radiation exposure of ≥ 20 Gray to dentition associated significantly with increased risk of ≥ 1 dental abnormality
Dose-dependent alkylating agent therapy significantly increased the risk of ≥ 1 anatomic/developmental dental abnormalities in survivors who were diagnosed at age < 5 years (OR, 1.7, 2.7, and 3.3 for alkylating agent scores of 1, 2, and 3, respectively)

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