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The aim of this work was to evaluate whether the cancer itself, age, sex, number of days of fever, and septic and fungal episodes affect the salivary samples and to assess the frequency of the development of caries during cancer. The background features for caries challenge were studied by monitoring changes in counts of salivary lactobacilli and candida for up to 1 year in 36 children during anti-cancer therapy (18 leukemias and 18 solid tumors). The first dental examination was performed at the diagnosis of cancer and a reexamination about 3 years later. The results showed that the children with active caries at the diagnosis of cancer had significantly more positive findings of lactobacilli and candida than did those with a sound dentition. The other background features did not affect the results. The follow-up dental examination showed that 86.7% of the children who had a caries-free dentition at the beginning of the survey were still in this state after 3 years. In conclusion, more attention should be paid to prophylaxis and dental treatment for cancer children with caries.

The effect of a low dose of glucocorticoids on dentin formation and progression of dental caries was studied in young rats. The animals were inoculated in the mouth with Streptococcus sobrinus and fed ad libitum a high-sucrose, a high-starch, or a reference diet. The cortisone or placebo pellet was implanted subcutaneously in the back of the necks of the animals. After a 6-week experimental period the areas of dentin formation and dentinal caries were quantified planimetrically. Schiff's staining was used to classify caries. Cortisone reduced the dentin formation both in high-starch and reference diets, but it did not further affect the reducing effect of the high-sucrose diet on dentin formation. Cortisone did not affect the number or severity of dentinal carious lesions.

Antineoplastic therapy causes developmental disturbances in the dental enamel and root if children are treated during tooth development. Increased caries activity has also been reported. The effect of anticancer therapy on the function of the masticatory system (i.e. jaws, dentition, masticatory muscles) is not well known. A case report of a 9-year-old girl with right auricular rhabdomyosarcoma is presented. She received irradiation of 50 Gy to the right auricular area and chemotherapy. A year and a half after cessation of cancer therapy, she was disease free and the clinical stomatognathic examination combined with electromyogram (EMG) registration of the masseter and temporal muscles and magnetic resonance imaging (MRI) examination of the temporomandibular joints (TMJ) revealed a strongly restricted mouth opening capacity, painful right TMJ, and flattened head of the right mandibular condyle. Muscle atrophy in the right masseter muscle was clearly visible but EMG activities of the masseter and temporal muscles, however, were higher on the right than on the left. More severe developmental defects, and worse gingival and cariological health were observed on the right side than on the left side. She developed 12 carious lesions and all the lesions were on the right maxilla or mandible or on anterior teeth. The left side was not affected. Intensive prophylactic dental care after cancer treatment is important in order to prevent caries and gingival inflammation. Stomatognathic treatment (i.e. management of occlusal and dysfunctional problems) may improve the mouth opening capacity and relieve pain.

Dental caries is an infectious disease and it may be harmful for children suffering from leukemia. DMFS, DMFT scores of forty-five children with acute lymphoblastic leukemia (ALL) were significantly higher than in healthy age-and-sex-matched controls after cessation of therapy. The children with CNS irradiation had higher DMFT (7.13 than children with only chemotherapy (3.4) and the controls (1.8). Lifelong caries incidence showed that children with ALL had 2.7 new caries lesions per year during the therapy compared to the 1.1 (p < 0.05) new lesions in controls. More detailed analysis of permanent anterior teeth at the age of twelve years showed that all patient groups had more filled anterior teeth than controls (p < 0.001); and children with bone marrow transplantation had significantly more fillings than the other two groups.

Osteoblasts and odontoblasts are both derived from the same mesenchymal cell line. Our aim was to investigate whether the processes of bone destruction and dentinal caries are biologically similar. The working hypothesis was that after the initiation of caries in the enamel, its rate of progression in the dentine is regulated by cell-mediated factors. Experimental caries was induced in the rat with a high sucrose diet combined with Streptococcus sobrinus infection. Both destruction of dentine and its apposition in the pulp under the carious lesions were measured after vital staining with tetracycline. Caries progression and dentine apposition were higher in developing teeth prior to apex "closure" than in adult, fully-formed teeth. Rats placed on a cariogenic diet during tooth development had an increased rate of caries progression. Fluoride administration via the drinking water was associated with decreased dentine apposition and little progression of dentine caries during the developmental stages. Dentine apposition was enhanced in adult rats placed on fluoride administration, while caries progression was reduced, whereas in animals subjected to metabolic acidosis dentine caries progression was enhanced, with reduced dentine apposition. In contrast, alkalotic animals had less dentinal lesions and smaller ones than the controls. Three theories are advanced to explain the observed changes: (i) They may be associated with changes in alkaline phosphatase activity in the pulpo-dentinal complex, (ii) they may be mediated by ionic changes in the dentinal fluid, or (iii) they may reflect the liberation of growth factors from dentinal matrix.

Because childhood cancer and/or its therapy is known to increase both dental caries and developmental defects in enamel, this experimental study was carried out to obtain information on the effect of two frequently used anticancer drugs, doxorubicin and methotrexate, on fissure caries and dentinal metabolism in healthy rats. Both drugs significantly reduced caries prevalence in the rat molars, the dentinal lesions that developed also being smaller than in the controls. Secondary dentin formation was slightly reduced, probably because of the lower caries prevalence in the rat molars and/or because of the action of the drugs. Thus, these two drugs could scarcely have been the reason for the increased caries activity in cancer patients.