Dental assessment prior to stem cell transplant: treatment need and barriers to care

Objective To assess the treatment needs of patients undergoing pre-haematopoietic stem cell transplant (HSCT) dental assessment, to collate the examination findings and treatment provided and to define the management issues impacting on care.Design Single centre retrospective analysis.Setting Salaried Primary Care Dental Service, Western General Hospital, Edinburgh, UK.Subjects and methods One hundred and sixteen available charts of patients who attended for pre-transplant dental assessment during April 2004-June 2007 were examined.Results Ninety-four patients, 52 men (55.3%) and 42 women (43.6%), were included. Patients were referred a mean of 31.5 (SD 18.82) days before admission for transplant. Dental assessment occurred, on average, 7.88 days (SD 6.78) following referral. Eighty-eight (93.6%) patients were dentate, while six (6.3%) were edentulous. Eighty-eight (93.6%) patients presented with oral disease; 89 (94.7%) patients received dental care. Issues impacting on care were medical (n = 88, 93.6%), time constraints (n = 73, 77.7%), no GDP (n = 25, 26.7%), dental complexity (n = 5, 5.3%) and anxiety management (n = 1, 1.1%).Conclusion The majority of patients required dental care, most of which, for healthy adults, would normally be completed within a primary care setting. However, the issues surrounding the care of patients destined for HSCT indicate that there is a place for a dedicated dental service as part of the multidisciplinary team.

Durey K, Patterson H, Gordon K.

GPT, Edinburgh Postgraduate Dental Institute, Floor 4, Lauriston Building, Lauriston Place, Edinburgh, EH3 9HA.