Oral Health Burden in Pediatric Cancer Survivors: Distinct Patterns in Solid and Hematologic Malignancies

To evaluate oral health parameters and associated risk factors in pediatric patients diagnosed with solid or hematologic malignant neoplasms.

A retrospective study was conducted by analyzing dental records and radiographs of 264 individuals aged 0-19 years treated at the Department of Dentistry in a Brazilian pediatric oncology referral center. Univariate and multivariate logistic regressions were performed.

The final sample comprised 141 individuals with solid tumors (ST) and 123 with hematologic tumors (HT). Chemotherapy was the most frequently used treatment modality, particularly among HT patients (p<0.001), whereas ST patients were more often treated with combined modalities. Gingivitis was significantly more frequent among HT patients (p < 0.001). Caries activity was observed in 58.5% of the sample, with no difference between groups, but was significantly associated with gingivitis and toothbrushing frequency, both identified as independent risk factors (OR = 3.05, 95% CI: 1.49-6.26, p = 0.002; OR = 1.46, 95% CI: 1.01-2.13, p = 0.046, respectively). Patients with ST had a higher likelihood of developing dental anomalies (OR = 24.07, 95% CI: 2.42-239.05, p = 0.007), and delayed tooth eruption was strongly associated with these anomalies (OR = 21.39, 95% CI: 2.25-202.92, p = 0.008).

Pediatric oncology patients exhibit a wide range of oral complications related to cancer and its treatment. Dental care is essential for the prevention and management of oral complications, contributing to treatment adherence and improving the quality of life of pediatric oncology patients.