Prevalence of Dental Caries in Adults Scheduled for Hematopoietic Stem Cell Transplantation: A Multicenter Study in a Polish Population.

Background

Preparing patients for oncological therapy requires the elimination of foci of infection in accordance with Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) guidelines. Complications of dental caries, such as abscesses, can lead to sepsis. In Poland, the pre-oncologic dental treatment of patients with hematopoietic disorders does not yet meet MASCC/ISOO standards; however, an inventory of the current status of dental care for these patients is ongoing. The aim of this study was to investigate the frequency of dental caries and to define the local caries risk factors in adult patients prior to Hematopoietic Stem Cell Transplantation (HSCT) as a part of anticancer therapy. Additionally, the time available for dental treatment was assessed.

Methods

A total of 302 patients were examined. Dental status was determined based on the number of decayed, missing and filled teeth and on treatment needs. Local caries risk factors, such as poor dietary habits, insufficient oral hygiene, and symptoms of reduced salivary flow, were examined. The diet was assessed using a questionnaire; tooth cleaning efficiency was assessed as a percentage of dental surfaces with biofilm. Symptoms of reduced salivary flow were determined by subjective and clinical signs of low salivary secretion.

Results

Active (progressive) dental caries was diagnosed in 85.2% of patients. Insufficient oral hygiene had been found in 71.52% of those examined. Symptoms of hyposalivation were present in 85% of patients. In 31% of cases, time available for dental treatment prior to HSCT was too short.

Conclusions

Tooth decay, the presence of caries risk factors, and insufficient time for oral treatment in patients submitted to HSCT represent a serious clinical problem. There is a clear need to establish comprehensive oral health protocols aimed at providing patients with appropriate, urgent dental care. Furthermore, coordination between oncologists and dentists in Poland must be improved. Currently patients are rarely referred to a dentist before starting anticancer therapy; those scheduled to hematopoietic stem cell transplantation, usually see a dentist too late.