Tooth Loss and Oral Health-related Quality of Life in a Sub-cohort Within the Chronic Graft-Versus-Host Disease Consortium.

Chronic graft-versus-host-disease (cGVHD) is a major complication of allogeneic hematopoietic cell transplantation (alloHCT) that frequently affects the oral cavity with manifestations of oral mucosal inflammation, salivary gland hypofunction, and trismus. However, the long-term consequences of oral cGVHD on oral health outcomes are not defined. This report assesses long-term tooth loss and oral health-related quality of life (OHRQL) measures in patients who have received alloHCT. Participants were evaluated at an initial post-transplant dental visit which consisted of dental and periodontal examination, oral mucosal examination, and panoramic radiographs. The National Institutes of Health (NIH) Modified Oral Mucosa Rating Scale (OMRS) and World Health Organization (WHO) Oral Health Assessment for Adults were used for diagnosis and grading of oral cGVHD and dental status. Pretransplant dental records were available and utilized to calculate tooth loss data. Participants also completed the Oral Health Impact Profile-14 (OHIP-14) questionnaire, the NIH mouth sensitivity score, the Lee Symptom Scale (oral cavity items), and the shortened summated Xerostomia Inventory (XI). This study enrolled 70 participants at a median of 8.8 years after alloHCT (range 6.7 to 11.8 years); 19 (27.1%) had no past oral cGVHD, 22 (31.4%) had past but no current oral cGVHD, and 29 (41.4%) had current oral cGVHD. Patients with current oral cGVHD had a mean tooth loss of 2.3, patients with past but no current oral cGVHD had a mean tooth loss of 1.0, and patients with no past oral cGVHD had a mean tooth loss of 2.1 (P = .54, ANOVA). The mean overall OHIP-14 scores for the current, past but no current, and no past oral cGVHD groups were 13.6, 6.3, and 6.3, respectively (P = .02, ANOVA). Oral cGVHD significantly impacted various aspects related to eating and meal choices. The rate of tooth loss was not definitively different based on past/current oral cGVHD status. Further efforts at mitigating the adverse impacts of oral cGVHD on nutrition and oral-health-related quality of life has the potential to improve the lives of alloHCT recipients.