IMPACT OF CONDITIONING REGIMENS ON SALIVARY FUNCTION, CARIES-ASSOCIATED MICROORGANISMS AND DENTAL-CARIES IN CHILDREN AFTER BONE-MARROW TRANSPLANTATION - A 4-YEAR LONGITUDINAL-STUDY

Salivary function, dental caries and caries-associated salivary microo rganisms were investigated in children undergoing BMT during a 4-year longitudinal study, Fourteen children were conditioned with CY and TBI and 12 with CY with or without BU, Four years after BMT the mean sali vary secretion rate was 1.3 +/- 0.7 ml/min in the chemotherapy group, compared to 0.7 +/- 0.5 in the TBI/CY group (P < 0.05), The mean saliv ary secretion rate fell from 0.9 +/- 0.5 ml/min before TBI to 0.2 +/- 0.1 after 3 months (P < 0.01), 0.3 +/- 0.3 ml/min after 6 months (P < 0.01) and 0.5 +/- 0.6, 1 year after TBI (P < 0.05), Mean reduction in stimulated salivary flow 3 months after TBI was 78% in the TBI/CY grou p compared to 36% in the chemotherapy group (P < 0.05), Children condi tioned with chemotherapy showed an increased salivary flow compared to baseline; this was not found in TBI-treated children, suggesting that damage to the salivary glands may be permanent, Four years after BMT, children conditioned with TBI had significantly higher counts of muta ns streptococci (P < 0.05) and lactobacilli (P < 0.01) compared to age -matched controls, However, the prevalence of dental caries did not di ffer between children conditioned with TBI, chemotherapy and healthy c ontrols.