Dental Needs of Oncology Inpatients at Seattle Children’s Hospital

Abstract

Background: Over 15,000 children and adolescents are diagnosed with cancer annually in the US. Guidelines suggest a dental examination be completed prior to starting cancer-directed therapies, but there is little data on the dental needs of these patients at the time of diagnosis. Purpose: To analyze and describe the characteristics and dental needs of newly diagnosed pediatric oncology patients in an academic, tertiary care center, based on their inpatient baseline evaluations. Study design: This study included all newly diagnosed patients with cancer for whom an inpatient consultation for baseline dental evaluation was requested from January 1, 2013 to December 31, 2016, with follow-up care not extending past December 31, 2017. Demographics, oncology diagnosis, medical comorbidities, timing of consultation, dental findings, and treatment recommended/rendered were recorded. Results: Amongst 861 inpatient dental consults, 296 (35%) were for newly diagnosed cancer patients. Seventy-nine percent of patients received a baseline exam prior to starting oncology therapy (p=<0.01). Patients who had not seen a dentist within twelve months prior to consult had increased odds of immediate dental needs, OR 3.75 (95% CI 1.43, 9.84). Fixed orthodontic appliances (braces) were significantly indicative of immediate dental needs, OR 22.8 (95% CI 7.66, 67.9). Conclusions: Most children with a new diagnosis of cancer for whom an inpatient dental consultation was ordered, received a baseline dental examination prior to starting oncological therapy. Fixed orthodontic appliances required the most immediate dental treatment. Treatment other than removal of orthodontic appliances was equally provided in the operating room and the clinic.