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Oral health of children undergoing allogeneic bone marrow transplantation
V S Lucas1, G J Roberts, D Beighton
1Department of Microbiology, Eastman Dental Institute, University of London, UK.
Insights
Children undergoing allogeneic bone marrow transplantation experienced significant oral health decline, including increased cavities and gum inflammation. Oral health improved by four months post-transplant, returning to baseline levels.
Area of Science:
- Pediatric Dentistry
- Hematology
- Immunology
Background:
- Allogeneic bone marrow transplantation (BMT) is a critical treatment for various pediatric conditions.
- Children undergoing BMT face unique challenges, including potential impacts on oral health due to immunosuppression and treatment protocols.
Purpose of the Study:
- To investigate the longitudinal changes in oral health parameters in children undergoing allogeneic BMT.
- To compare the oral health status of pediatric BMT patients with matched controls.
Main Methods:
- A cohort of 23 children undergoing allogeneic BMT and matched controls were assessed.
- Oral health parameters including decayed, missing, and filled teeth/surfaces, bacterial plaque index, gingival inflammation index, and mucositis were measured at baseline, 7 days, and 4 months post-transplantation.
Main Results:
- Baseline assessment revealed significantly more decayed, missing, and filled surfaces in deciduous teeth among transplant patients compared to controls.
- A significant increase in bacterial plaque and gingival inflammation scores for both deciduous and permanent teeth was observed at 7 days post-transplantation.
- Oral health parameters, specifically plaque and gingival inflammation scores, returned to baseline levels by 4 months post-transplantation.
Conclusions:
- Allogeneic bone marrow transplantation is associated with a significant, albeit temporary, decline in pediatric oral health, particularly during the period of intense immunosuppression.
- Close monitoring and management of oral hygiene are crucial for children undergoing allogeneic BMT to mitigate treatment-related complications.
Abstract:
The objective of this study was to investigate changes in the oral health of children undergoing allogeneic bone marrow transplantation. The study group comprised 23 children undergoing allogeneic bone marrow transplantation and their matched controls. The study group comprised 23 children undergoing allogeneic bone marrow transplantation and their matched controls. Measurements were taken of the mean decayed, missing and filled surfaces and the mean decayed, missing and filled teeth in both deciduous and permanent dentition at baseline, the mean bacterial plaque and gingival inflammation indices and mucositis at specific event-related times during the transplantation period, were measured. The number of decayed, missing and filled surfaces in deciduous teeth was significantly greater in the transplant children than the matched controls (P < 0.05) at baseline. There was a significant increase in both the mean bacterial plaque score for the deciduous teeth (P < 0.003) and the permanent teeth (P < 0.001) and the mean gingival inflammation score for the deciduous (P < 0.001) and the permanent teeth (P < 0.001), at 7 days post-transplantation. At 4 months post-transplantation the plaque and gingival inflammation score had returned to baseline levels. There were significantly increased mean bacterial plaque and gingival inflammation scores during the period of intense immunosuppression following allogeneic bone marrow transplantation.