Dental Adverse Effects Following Multimodality Treatment for Head and Neck Rhabdomyosarcoma: Results of a Trans-Atlantic Multicentre Study

Abstract

Introduction: As survival of paediatric cancer improves, more emphasis is placed on late adverse effects. However, the dental and periodontal adverse effects of cancer treatments in children remain an underinvestigated complication. This study aims to investigate the prevalence of late clinical dental adverse effects (cDAE) in survivors of paediatric head and neck rhabdomyosarcoma (HNRMS). Methods: Between 2017 and 2019, data were collected as part of a collaborative study between four international centres. During a ‘late adverse effect clinic’, dentists examined HNMRS survivors who were treated using multimodality treatments for dental and periodontal adverse effects using the following validated index scores ‘Simplified Oral Hygiene Index’ (SOHI), the ‘Decayed, Missing and Filled Teeth’ (DMFT) score and the ‘Dutch Periodontal Screening Index’ (DPSI). Results: Forty-six survivors, with a median follow-up of 9.9 years (range: 2–29.7 years), were included. Of these survivors of HNRMS, 89.1% had significant plaque accumulation. The median DMFT score was 3.00 (range: 0–26), which is considered normal. However, approximately a quarter of the survivors had exceptionally high DFMT scores, indicating many teeth were missing or filled. Affected gingivae, unhealthy gums, were seen in 67.4% of survivors of HNRMS. Conclusion: Survivors of HNRMS have higher plaque and gingivitis rates, possibly due to cancer treatment or poor oral hygiene and diet. Next to regular care, additional monitoring of oral health and support of oral hygiene are indicated. Survivors, parents and physicians should be aware of the dental and periodontal risks and ensure proper care is available.