[Severe hard tooth structure decay following full body radiotherapy prior to bone marrow transplantation]

A case of severe hard tooth structure decay in a patient aged 31 following bone marrow transplantation is presented. So far tooth decay of such severity was only found in connection with radiotherapies for oral and maxillofacial malignomas. Scanning electron micrographs of 4 extracted teeth reveal different degrees of enamel and dentine decay. Major areas of exposed dentine, particularly at the buccal and incisal surfaces where the enamel has broken off in splinters, show massive growth of bacteria. The dentinoenamel junction is also extensively involved. Implications for dental care of bone marrow transplant patients during and after treatment are being discussed.