Dental evaluation and clearance prior to allogeneic hematopoietic cell transplantation

• Published in: Oral diseases Vol. 30; no. 4; pp. 2635 - 2644
• Main Authors: Dean, David, Lee, Stephanie J., Cutler, Corey, Gooley, Ted A., Hujoel, Philippe, Oh, Uhlee (Yuri), Bennett‐Johnson, Lisa, Hagstrom, Mary K., Rothen, Marilynn, Lloid, Michele, Sroussi, Herve, Treister, Nathaniel
• Format: Journal Article
• Language: English
• Published: Denmark Wiley Subscription Services, Inc 01.05.2024
• Subjects: Allografts; Dental caries; Dental disorders; dental evaluation and management; Dental prosthetics; Endodontics; Health care access; Health risks; hematopoietic stem cell transplant; Hematopoietic stem cells; immunosuppression; Infections; Medical records; Medical treatment; Neutropenia; Oral infection; Oral medicine; Patients; Prophylaxis; Root canals; Stem cell transplantation; supportive care; Teeth; Transplantation; Oral medicine; immunosuppression; dental evaluation and management; Oral infection; supportive care; hematopoietic stem cell transplant
• ISSN: 1354-523X; 1601-0825; 1601-0825
• DOI: 10.1111/odi.14717

Introduction Dental examination and stabilization are performed prior to allogeneic hematopoietic cell transplantation to decrease infection risk during neutropenia. Burden of dental disease and treatment need is not well characterized in this population. Objectives This report describes the dental status of a cohort of patients within the Chronic Graft‐versus‐Host Disease Consortium and treatment rendered prior to transplant. Methods The cohort included 486 subjects (Fred Hutchinson: n = 245; Dana‐Farber: n = 241). Both centers have institutional‐based dental clearance programs. Data were retrospectively ed from medical records by calibrated oral health specialists. Results The median age at transplant was 55.9 years, 62.1% were male, and 88% were white. Thirteen patients were edentulous (2.7%). The mean teeth among dentate patients before clearance was 26.0 (SD, 4.6). Dental findings included untreated caries (31.2%), restorations (91.6%), endodontically treated teeth (48.1%), and dental implants (5.7%). Pretransplant procedures during clearance included endodontic therapy (3.6%; mean = 0.1 teeth), restorations (25.1%; mean = 0.7), dental prophylaxis (59.2%), scaling/root planing (5.1%), and extraction (13.2%; mean = 0.3). The mean teeth after clearance was 25.6 (SD, 5.0). Conclusions Retrospective analysis of pre‐AlloHCT dental data in subjects at two large transplant centers identified low levels of dental need. Findings suggest high access to care.