Long term dental and oral sequelae in patients following anticancer therapy

The Advances in therapeutic strategies for common pediatric cancers has led to an increase in number of childhood cancer survivors (CCS). The cytotoxic chemotherapy, radiotherapy, hematopoietic cell transplantation (HCT), immunotherapy, and targeted therapies or regimens are various modalities used for management. Antineoplastic chemotherapy remains one of the most widely used management strategies in cancer, either alone or in combination with other type of treatments. An important disadvantage of chemotherapy is its lack of selectivity, since it acts upon both tumor (neoplastic) cells and rapidly multiplying normal cells. Leads to acute complications in majority but often results in permanent damage to organ systems giving rise to late complications that become clinically apparent after many years. Almost 75% of CCS experience one or more late adverse health effects depend on the type of therapy, patient characteristics, tumor-related factors, genetic susceptibility, and lifestyle factors later in life. The effects of anticancer therapy on dental structures can be broadly classified into 1. Direct effects -Enamel (Enamel hypoplasia, enamel pitting, or missing enamel), Dentin (Microdontia, short roots, V-shaped roots), Pulp (Pulp calcification) and Tooth initiation (Tooth agenesis, Hypodontia, Root agenesis) whereas those results from combination of direct and indirect effects includes dental Caries, and periodontal problems (Gingivitis, periodontitis, premature exfoliation).