Child cancers: managing the complications of childhood chemotherapy in the adult dentition

Chemotherapy is the first line treatment employed in treating many childhood cancers such as leukaemia and lymphoma and has resulted in improved survival rates. A recent report found that predicted five-year survival rate for children and adolescents who were diagnosed with cancer has risen by up to 82%.¹

The severity of the malignant disease usually dictates the concentration, toxicity and duration of chemotherapy to which the child is subjected during treatment. Typically, this chemotherapy regimen can last from 1 to 3 years.

Previous studies have looked at children who were in long-term remission from cancers of different types. Hypodontia, as well as hypoplasia of the crowns of the teeth, were the most commonly reported dental abnormalities.^2,3

The malformation of the crowns, pulps and roots of adult teeth are usually closely linked to the age of the child when the toxic, albeit life-saving, chemotherapy was commenced. This is due to its impact on the process of amelogenesis and dentinogenesis at the age at which the teeth are forming. For instance, the crowns of the deciduous dentition are completely developed very early on and, if chemotherapy starts after that, these teeth will not be affected, but the adult teeth developing will be.