Oral disease burden in children and adolescents scheduled for allogeneic hematopoietic stem cell transplantation – a multicenter study

Purpose Hematopoietic stem cell transplantation (HSCT) is a curative treatment for various hematologic and non-hematologic disorders. The oral cavity, acting as a reservoir for infections, poses additional risks for patients undergoing HSCT. This study aimed to assess the burden of oral disease in children and adolescents preparing for allogeneic (a)HSCT and to evaluate the oral healthcare received before transplantation. Methods This prospective, longitudinal, multicentre cohort study included 91 children and adolescents under 18 years old scheduled for an aHSCT. Results The mean age of the cohort was 11.2 ± 4.6 years, with the most common diagnosis being acute leukaemia (47%), followed by non-malignant haematological disorders (15%). The prevalence of patient-reported oral symptoms was 49%, with sensitivity to hot and cold temperatures (10%) and loose teeth (7%) being the most common complaints. Dental caries was present in 37%, and 13% had visible dental plaque on more than half of their teeth. Dental extractions were performed in 24% of patients, and 22% received dental restorations. Conclusion Children and adolescents scheduled for aHSCT face a significant burden of oral disease, with notable dental issues that must be addressed before transplantation. This study highlights the importance of pre-transplant dental evaluations in addressing remaining dental concerns and minimizing post-transplant complications.