THE ORAL HEALTH OF LONG-TERM SURVIVORS OF ACUTE LYMPHOBLASTIC-LEUKEMIA - A COMPARISON OF 3 TREATMENT MODALITIES

Sixty-eight children who were diagnosed with acute lymphoblastic leuka emia (ALL) prior to age 5 years and treated with chemotherapy alone, c hemotherapy plus 1800 cGy cranial irradiation (RT), or chemotherapy pl us 2400 cGy RT were assessed clinically for overall dental health. All patients were at least 60 months in continuous remission. Dental cari es were assessed by NIDR diagnostic criteria, oral hygiene was assesse d by the modified Oral Hygiene Index, and gingival health was assessed by the modified gingival index of Loe and Silness. There was no signi ficant difference in caries experience between the three groups nor wi th the normal population. Those patients that received 2400 cGy RT had significantly higher plaque and periodontal index scores than patient s in the other treatment groups. The results of this study suggest tha t: (1) children with ALL treated with any of the described modalities are at no greater risk of developing dental caries than the normal pop ulation; and (2) patients receiving 2400 cGy prior to age 5 years are at greater risk of developing periodontal disease than patients treate d with other central nervous system prophylaxis regimens examined in t his study.