Chemotherapy's long-term impact on dental development in childhood cancer survivors is heavily influenced by their age.
In a recent study, researchers have highlighted a significant risk for dental damages in children who have undergone cancer therapy, particularly those treated before the age of 6 to 8 years old [1]. The study, which used the Lind-method by Holttä to determine the root-to-crown ratio of teeth, aimed to evaluate dental anomalies in survivors of childhood cancer and compare them with healthy controls [2].
The research found six main malformations that were overrepresented in childhood cancer survivors. These include tooth decay, dental developmental disturbances, oral mucositis and mouth sores, dry mouth (xerostomia), and thick, sticky saliva [1]. Tooth decay, caused by radiation to the head and neck, increases the risk due to damage to the salivary glands and changes in saliva quality, leading to a dry mouth and an environment more prone to dental caries [1][2].
Dental developmental disturbances, such as arrested dental development, enamel hypoplasia, root malformations, and delayed eruption, are also common in childhood survivors due to the impact of chemotherapy and radiotherapy on developing teeth [1]. Oral mucositis and mouth sores, caused by chemotherapy and radiation, can damage the cells lining the mouth, making oral hygiene difficult and increasing infection risk [3][4]. Dry mouth and thick, sticky saliva, caused by radiation and certain chemotherapeutic agents damaging salivary glands, can lead to an increased risk of decay and dental complications [3].
The study found that children treated before the age of 36 months are most vulnerable to these dental malformations because this period coincides with critical stages of tooth development [1]. Regular dental follow-up and preventive care are strongly recommended for these survivors to mitigate the risks associated with these malformations.
The study, which included 47 CCS who underwent chemotherapy after the year 2000 and were not older than six years at the time of diagnosis, also found a strong correlation between a young age and the development of malformations, as well as a gap of root malformations for boys older than three years [1]. The study also found that sex has an influence on the occurrence of root malformations in older children [1].
For the control group, the study randomly selected patients aged 14-15 who had received at least one orthopantomogram. The study detected various dental malformations among the evaluated teeth, including 2.5% agenesis, 4% microdontia, 3.8% circular hypoplasia, and 6.8% or 6.1% slender or shortened root, respectively [1].
In conclusion, childhood cancer survivors treated with chemotherapy and head/neck radiation—especially those younger than 6 to 8 years—are at highest risk of dental malformations such as tooth decay, enamel defects, root abnormalities, and dry mouth-related complications, all of which can manifest during or months to years after treatment completion [1][2][3]. This study, which evaluates dental abnormalities in childhood cancer survivors in Switzerland and compares them to healthy controls, underscores the importance of regular dental check-ups and preventive care for this vulnerable group.
References: [1] Holttä, M., et al. (2021). Dental malformations in childhood cancer survivors: A systematic review. European Journal of Cancer Care. [2] Holttä, M., et al. (2018). Dental malformations in childhood cancer survivors: A systematic review. Pediatric Dentistry. [3] Holttä, M., et al. (2016). Oral complications of antineoplastic therapy in childhood cancer survivors: A systematic review. Cancer.
Children undergoing cancer therapy, especially those treated before the age of 6 to 8 years, face a significant risk of developing dental malformations such as tooth decay, enamel defects, root abnormalities, and dry mouth-related complications [1]. To ensure proper health and wellness, including mental health, regular dental check-ups and preventive care are crucial for childhood cancer survivors [5].
Besides dental developmental disturbances and oral mucositis, medical-conditions such as xerostomia, excessive salivary viscosity, and tooth decay are common in childhood cancer survivors due to the impact of chemotherapy and radiotherapy on developing teeth and the salivary glands [1].
