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Juliette Stolze

Juliette Stolze

PhD student, dentist

Late oral effects in long-term survivors of paediatric cancers, following different treatment regimens.

Phone 088 97 25 192

So far the research on late effects in childhood cancer survivors (CCS) has primarily been focused on major organ systems, e.g. heart or kidney dysfunction. However until now no studies on late effects on the oral cavity have been performed in a large cohort of CCS.

Saliva is of paramount importance for the maintenance of the oral health. During treatment for childhood cancer, patients often experience a decreased salivary secretion (hyposalivation) and/or the subjective feeling of a dry mouth (xerostomia). However, limited data exist on the prevalence of chronic hyposalivation and xerostomia in CCS. Hyposalivation is a severe, and probably under-estimated late effect. Complications arising from hyposalivation are bothersome and may negatively affect oral as well as general health.

The dental system, still in development and maturation during childhood cancer treatment, can also present late effects of chemotherapy and/or radiotherapy. Several developmental anomalies have been described, such as tooth agenesis, hypodontia, microdontia and disturbed root development. A younger age at diagnosis is associated with a higher risk for long-term dental effects. However, it is still unknown to what extent the different treatment modalities of CCS may have different dental effects, and what impact dental effects have on the oral health-related quality of life of CCS survivors.

Aims of the study

  • To assess the prevalence of hyposalivation, xerostomia and dental effects in CCS treated with different treatment modalities
  • To obtain a better insight into patient-related and treatment-related risk factors for long-term oral effects
  • To assess the correlation between long-term effects and oral-health-related quality of life

The results of this study will identify CCS at risk for hyposalivation and/or xerostomia and/or dental effects and will provide information for screening guidelines during long term follow-up. The  DCOG LATER guideline for follow-up, might be revised accordingly. Interventions in CCS with hyposalivation and/or xerostomia and/or dental effects aimed at preventing dental caries, oral mucosal infections, improving function and alleviating complaints of dry mouth are essential to improve their oral and general health and we anticipate that this will have a positive impact on their quality of life.

Supervisor(s): H.S. Brand, D. Bresters, J.E. Raber-Durlacher, J.C. Teepen, J. Loonen, L.M.C. Kremer.