Salivary flow rate, subjective oral dryness and dental caries 5 years after haematopoietic cell transplantation

• Published in: BMC oral health Vol. 24; no. 1; pp. 1058 - 11
• Main Authors: Bulthuis, Marjolein S, van Gennip, Lucky L A, Thomas, Renske Z, van Leeuwen, Stephanie J M, Bronkhorst, Ewald M, Laheij, Alexa M G A, Raber-Durlacher, Judith E, Blijlevens, Nicole M A, Huysmans, Marie-Charlotte D N J M
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 10.09.2024; BioMed Central; BMC
• Subjects: Adult; Aged; Cancer survivors; Cancer therapies; Dental caries; Dental Caries - etiology; Dental health; Dentists; Ethics; Female; Haematopoietic stem cell transplantation; Health aspects; Hematopoietic Stem Cell Transplantation - adverse effects; Hematopoietic stem cells; Humans; Kinases; Likert scale; Long term adverse effects; Longitudinal Studies; Male; Mechanical properties; Middle Aged; Netherlands; Risk factors; Saliva; Saliva - metabolism; Salivary glands; secretions; Secretory Rate; Side effects; Statistics; Stem cell transplantation; Survivor; Transplantation; Xerostomia; Xerostomia - etiology; Xerostomia - physiopathology; Netherlands; Cancer survivors; Haematopoietic stem cell transplantation; Dental caries; Long term adverse effects; Xerostomia
• ISSN: 1472-6831; 1472-6831
• DOI: 10.1186/s12903-024-04804-7

The aim of this study was to describe salivary flow rate, subjective oral dryness and dental caries 5 years post haematopoietic cell transplantation (HCT). HCT survivors of a previous longitudinal observational cohort study in the Netherlands (the H-OME study) were invited to participate in this additional follow-up after 5 years (the HOME2 study). During the additional follow-up appointment, stimulated (SWS) and unstimulated whole saliva (UWS) was collected, participants rated subjective oral dryness on a 0 - 10 scale, and caries lesions were assessed. Furthermore, dental records, including treatments and radiographs, were requested for the 5 years preceding and the 5 years following transplantation. Paired t-tests were performed to determine changes in UWS and SWS flow rates and subjective oral dryness from pre-HCT, and to compare the number of caries-related dental treatments (restorations, endodontic treatments or extractions) before and after HCT. Hyposalivation of UWS (< 0.2 mL/min) and SWS (< 0.7 mL/min) at 3 and 12 months, was used to explore the predictive potential of hyposalivation on a high dental treatment need (> 3 treatments) over the 5 years post-HCT. Five years post-HCT, 39 HCT survivors were included. The mean UWS flow rate was 0.36 mL/min (SD 0.26) and the mean SWS flow rate 1.02 (SD 0.57); survivors were diagnosed with a median of 0 dentine lesions (range 0 - 12) and 73% reported a subjective oral dryness score ≥ 1. Survivors underwent a median of 3 (range 0 - 20) dental treatments during the 5 years following transplantation. The mean difference in UWS 5 years post-HCT compared to pre-HCT was 0.03 (95% CI: -0.07 - 10.12), the mean difference for SWS was -0.18 (95% CI: -0.45 - 0.08) and for subjective oral dryness 1.2 (95% CI: 0.2 - 2.1). In the 5 years post-HCT, non-significantly more treatments were performed compared to the 5 years pre-HCT (mean difference: 0.5, 95%CI: -1.2 - 2.2). Seventy eight percent of patients with hyposalivation of SWS at 12 months had a high dental treatment need, compared with 38% with no hyposalivation. Five years post-HCT, mean UWS and SWS flow rates were not significantly different from pre-HCT levels but subjective oral dryness scores were elevated.