Oral health in patients scheduled for hematopoietic stem cell transplantation in the Orastem study

PLoS One. 2023 May 18;18(5):e0285615. doi: 10.1371/journal.pone.0285615. eCollection 2023.

Abstract

Despite advances in transplant medicine, prevalence of complications after hematopoietic stem cell transplantation (HSCT) remains high. The impact of pre-HSCT oral health factors on the incidence and severity of complications post-HSCT is poorly understood. The aim of this prospective, observational study was to analyze oral health in patients planned for HSCT. Patients ≥18 years requiring HSCT were included from five sites between 2011-2018. General health, oral findings and patient-reported symptoms were registered in 272 patients. Oral symptoms around disease onset were reported by 43 patients (15.9%) and 153 patients (58.8%) reported oral complications during previous chemotherapy. One third of patients experienced oral symptoms at the oral examination before conditioning regimen and HSCT. In total, 124 (46.1%) patients had dental caries, 63 (29.0%) had ≥one tooth with deep periodontal pockets, 147 (75.0%) had ≥one tooth with bleeding on probing. Apical periodontitis was observed in almost 1/4 and partially impacted teeth in 17 (6.3%) patients. Oral mucosal lesions were observed in 84 patients (30.9%). A total of 45 (17.4%) of 259 patients had at least one acute issue to be managed prior to HSCT. In conclusion, oral symptoms and manifestations of oral disease were prevalent in patients planned for HSCT. The extent of oral and acute dental diseases calls for general oral screening of patients pre-HSCT.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Dental Caries* / complications
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Humans
  • Mouth Diseases* / diagnosis
  • Mouth Diseases* / epidemiology
  • Mouth Diseases* / etiology
  • Oral Health
  • Prospective Studies
  • Transplantation Conditioning / adverse effects

Grants and funding

This study was funded by grants from Stiftelsen Wilhelm och Martina Lundgrens Vetenskapsfond, https://wmlundgren.se/vetenskapsfonden/ (2020-3569) to B.H.; the Local Research and Development Council for Gothenburg and Södra Bohuslän Region Västra Götaland, https://www.researchweb.org/is/gsb (VGFOUGSB-932842) to K.S.; the Dutch Cancer Society, https://www.kwf.nl/ (ACTA 2014-7468; trial register NTR5760) to J.D., N.B., F.R., M.H.; Göteborgs Tandläkare-Sällskap, https://goteborgstandlakaresallskap.nu/ to K.S.; Stiftelsen Assar Gabrielssons´ Fond, https://www.agfond.se (FB20-23 and FB21-55) to K.S.; the Public Dental Health Organization in Värmland Region, https://www.regionvarmland.se/tandvard to I.v.B.; TUA Research Funding; the Sahlgrenska Academy at University of Gothenburg/Region Västra Götaland, https://www.researchweb.org/is/tuagbg (TUAGBG-135781) to I.v.B.; internal funding from Atrium Health Carolinas Medical Center, Charlotte, NC, https://atriumhealth.org/research to M.B. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.