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A Systematic Review of Dental Disease in Patients Undergoing Cancer Therapy
Supportive Care in Cancer
  • Catherine H.L. Hong, Carolinas Medical Center
  • Joel J. Napeñas, Carolinas Medical Center
  • Brian D. Hodgson, Marquette University
  • Monique A. Stokman, University of Groningen
  • Vickie Mathers-Stauffer, Penrose Cancer Center
  • Linda S. Elting, The University of Texas MD Anderson Cancer Center
  • Fred K.L. Spijkervet, University of Groningen
  • Michael T. Brennan, Carolinas Medical Center
Document Type
Format of Original
15 p.
Publication Date

Introduction: The purpose of this systematic review was to evaluate the literature and update our current understanding of the impact of present cancer therapies on the dental apparatus (teeth and periodontium) since the 1989 NIH Development Consensus Conference on the Oral Compli­cations of Cancer Therapies.

Review Method: A systematic literature search was con­ducted with assistance from a research librarian in the databases MEDLINE/PubMed and EMBASE for articles published between 1 January 1990 and 31 December 2008. Each study was independently assessed by two reviewers. Taking into account predetermined quality measures, a weighted prevalence was calculated for the prevalence of dental caries, severe gingival disease, and dental infection. Data on DMFT/dmft, DMFS/dmfs, plaque, and gingival indexes were also gathered. The level of evidence, recommendation, and guideline (if possible) were given for published preventive and management strategies.

Results: Sixty-four published papers between 1990 and 2008 were reviewed. The weighted overall prevalence of dental caries was 28.1%. The overall DMFT for patients who were post-antineoplastic therapy was 9.19 (SD, 7.98; n=457). The overall plaque index for patients who were post­antineoplastic therapy was 1.38 (SD, 0.25; n=189). The GI for patients who were post-chemotherapy was 1.02 (SD, 0.15; n=162). The weighted prevalence of dental infections/ abscess during chemotherapy was reported in three studies and was 5.8%.

Conclusions: Patients who were post-radiotherapy had the highest DMFT. The use of fluoride products and chlorhex­idine rinses are beneficial in patients who are post-radiotherapy. There continues to be lack of clinical studies on the extent and severity of dental disease that are associated with infectious complications during cancer therapy.


Published version. Supportive Care in Cancer, Vol. 18, No. 8 (August 2010): 1007-1021. DOI. © 2010 The Authors. This article is published with open access at

Citation Information
Catherine H.L. Hong, Joel J. Napeñas, Brian D. Hodgson, Monique A. Stokman, et al.. "A Systematic Review of Dental Disease in Patients Undergoing Cancer Therapy" Supportive Care in Cancer (2010) ISSN: 0941-4356
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