Dental Diseases and Risk Assessment in Pediatric Hematopoietic Stem Cell Transplant Patients

Objective In this study, we aimed to evaluate the distribution of oral diseases in pediatric patients with hematological disorders and their impact on hematopoietic stem cell transplantation (HSCT). Methods We reviewed the pre-transplant oral examinations and HSCT inpatient records of pediatric patients at Peking University People's Hospital between 2020 and 2022. By reviewing pretransplant dental and inpatient medical records during transplantation, general information, oral examination and treatment information, and systemic and oral conditions during the transplantation process were recorded. All the statistical analyses were performed using these data. Results A total of 168 valid medical records were collected, comprising 119 males and 49 females with an average age of 10.49 years. The overall oral disease prevalence is 76.79%, the most common oral diseases were dental caries and pulp disease (48.81%), followed by gingivitis (35.71%). Oral mucositis occurred in 71 patients (42%) during transplantation. The gender (P = 0.020), age (P = 0.002) hematologic disease (P = 0.037), stem cell source (P = 0.044), and proportion of children with gingivitis (P < 0.001) and impacted teeth (P = 0.040) were significantly different in the OM group than that in the non-OM group. The results of the multivariate logistic regression analysis showed only age (P = 0.043) and gingivitis (P < 0.024) were risk factors for the onset of OM. Pre-transplant treatments in 10 patients included tooth extraction (7), resin filling (4), and root grinding (1). None of these 10 patients experienced odontogenic complications during transplantation. Two patients developed odontogenic complications; however, the transplantation process was not hindered after prompt treatment. Conclusion A high prevalence of oral disease was observed in pediatric patients who underwent HSCT. Untreated gingivitis and age are associated with Oral Mucosal (OM) disease. Odontogenic complications associated with transplantation are rare and controllable.