Reduced Salivary Flow Rate and Increased Caries Susceptibility in Italian Children in Remission from Hematological Malignancy

Featured Application: Considering that saliva is the major local defense mechanism in the oral cavity, screening for hyposalivation in children in remission from hematological malignancy is suggested to provide supportive care aimed at improving oral health. Salivary gland dysfunction is an underestimated oral late effect of chemotherapy in childhood cancer survivors (CCS). Therefore, the aim of this cross-sectional study was to assess the salivary functioning and dental caries experience in Italian CSSs and age- and gender-matched healthy children. A total of 32 children (15 females and 17 males, age range 6-14 years) in remission from hematological malignancy and 32 healthy controls were compared for salivary parameters (stimulated whole salivary flow rate, pH, and buffer capacity) and presence of carious lesions in the primary and permanent dentition using the dmft/DMFT indexes. Significantly lower stimulated whole saliva (SWS) and pH were observed in CSS than in healthy pediatric patients (both p < 0.001), together with a higher prevalence of carious lesions on both the deciduous (p = 0.002) and permanent teeth (p = 0.015). SWS was more severely impaired in children treated with chemotherapy before 5 years of age (p < 0.001) and, in spite of the tendency to improve over time, low SWS was still observed after 5-9 years of disease remission. According to the present data, chemotherapy has a detrimental effect on salivary gland functioning, which would seem to maintain up to 9 years after antineoplastic treatment.