Dyer G, Brice L, Schifter M, Gilroy N, Kabir M, Hertzberg M, Greenwood M, Larsen S R, Moore J, Gottlieb D, Huang G, Hogg M, Brown L, Tan J, Ward C, Kerridge I
Blood and Marrow Transplant Network, New South Wales Agency for Clinical Innovation, Sydney, New South Wales, Australia.
Northern Clinical School, Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia.
Aust Dent J. 2018 Jun 7. doi: 10.1111/adj.12627.
Oral and dental disease is a major cause of long-term morbidity following allogeneic blood and marrow transplantation (Allo-BMT). This study aimed to describe the extent and range of oral and dental complications in BMT recipients and to identify gaps in service provision provided to this high-risk group.
Participants were Allo-BMT recipients, aged >18 years, and received transplants between 2000 and 2012 in NSW. They completed seven surveys, the purpose-designed Sydney Post-BMT Study survey and six other validated instruments.
Of 441 respondents, many reported dry mouth (45.1%), dental caries (36.7%), mouth ulcers (35.3%), oral GVHD (35.1%), gingivitis (16.2%), tooth abscess (6.1%) and oral cancer (1.5%). Regular dental visits were reported by 66.2% of survivors. Middle-high income, older age and geographic location showed a positive association with regular dental visits. Of those who did not visit the dentist regularly, 37% stated they did not feel it necessary, 36% reported cost and 20% stated it was not advised by the treating team.
Despite oral complications commonly occurring after Allo-BMT, many survivors receive inadequate dental care. These results emphasize the need for improved oral health education, the importance of regular dental checks and improvement in the delivery of dental health services for BMT survivors.
口腔和牙齿疾病是异基因造血干细胞移植（Allo-BMT）后长期发病的主要原因。本研究旨在描述造血干细胞移植受者口腔和牙齿并发症的程度和范围，并找出为这一高危群体提供的服务中存在的差距。
研究对象为年龄大于18岁、2000年至2012年期间在新南威尔士州接受移植的Allo-BMT受者。他们完成了七项调查，即专门设计的悉尼造血干细胞移植后研究调查以及其他六项经过验证的工具。
在441名受访者中，许多人报告有口干（45.1%）、龋齿（36.7%）、口腔溃疡（35.3%）、口腔移植物抗宿主病（35.1%）、牙龈炎（16.2%）、牙脓肿（6.1%）和口腔癌（1.5%）。66.2%的幸存者报告定期看牙医。中高收入、年龄较大和地理位置与定期看牙医呈正相关。在那些不定期看牙医的人中，37%表示他们觉得没有必要，36%报告是费用问题，20%表示治疗团队不建议这样做。
尽管Allo-BMT后口腔并发症普遍存在，但许多幸存者的牙齿护理不足。这些结果强调了改善口腔健康教育的必要性、定期牙齿检查的重要性以及改善为造血干细胞移植幸存者提供的牙齿健康服务。
