Long-term effect of anticancer therapy on dentition of Italian children in remission from malignant disease: A cross-sectional study

Aim To investigate the effects of anticancer therapy on dental development and caries formation in Italian childhood cancer survivors compared to healthy controls. Methods A total of 52 children treated with chemotherapy and/ or radiotherapy when younger than 10 years and in remission from at least 2 years, and 52 healthy age and gender-matched children were consecutively enrolled in this cross-sectional study. All participants were examined for dental caries and enamel defects according to the decayed-missing-filled teeth (dmft/DMFT) index and the Aine rating scale. Panoramic radiographs were taken to estimate dental age and to assess dental abnormalities using the Höltta Defect Index. Results Compared to healthy controls, children in remission from malignant diseases showed increased prevalence of dental abnormalities and enamel defects in the permanent dentition, more teeth with active carious lesions and higher dental age (p <0.05). The almost totality of dental agenesis and microdontia were detected in patients treated with stem cell transplantation when younger than 5 years of age, while no difference between radiotherapy and chemotherapy was observed. Conclusion These children are at high risk for tooth developmental abnormalities and poor dental health and should be closely monitored by a specialist dentist.