Table 4. Oral/Dental Late Effects
| Predisposing Therapy | Oral/Dental Effects | Health Screening/Interventions |
| CT = computed tomography; GVHD = graft-versus-host disease; MRI = magnetic resonance imaging. | ||
| Any chemotherapy; radiation impacting oral cavity | Dental developmental abnormalities; tooth/root agenesis; microdontia; root thinning/shortening; enamel dysplasia | Dental evaluation and cleaning every 6 months |
| Regular dental care including fluoride applications | ||
| Consultation with orthodontist experienced in management of irradiated childhood cancer survivors | ||
| Baseline panorex prior to dental procedures to evaluate root development | ||
| Radiation impacting oral cavity | Malocclusion; temporomandibular joint dysfunction | Dental evaluation and cleaning every 6 months |
| Regular dental care including fluoride applications | ||
| Consultation with orthodontist experienced in management of irradiated childhood cancer survivors | ||
| Baseline panorex prior to dental procedures to evaluate root development | ||
| Radiation impacting oral cavity; hematopoietic cell transplantation with history of chronic GVHD | Xerostomia/salivary gland dysfunction; periodontal disease; dental caries; oral cancer (squamous cell carcinoma) | Dental evaluation and cleaning every 6 months |
| Supportive care with saliva substitutes, moistening agents, and sialogogues (pilocarpine) | ||
| Regular dental care including fluoride applications | ||
| Radiation impacting oral cavity (≥40 Gy) | Osteoradionecrosis | History: impaired or delayed healing following dental work |
| Exam: persistent jaw pain, swelling or trismus | ||
| Imaging studies (x-ray, CT scan and/or MRI) may assist in making diagnosis | ||
| Surgical biopsy may be needed to confirm diagnosis | ||
| Consider hyperbaric oxygen treatments | ||
