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Dental treatment before haematopoietic stem cell transplantation - a service evaluation

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Abstract

Introduction National guidance by the Royal College of Surgeons (England) recommends a dental assessment and necessary treatment before haematopoietic stem cell transplantation (HSCT). Within the special care dentistry department in Liverpool University Dental Hospital, patients are assessed before transplant; however, the efficiency and efficacy of the service was unknown and therefore a service evaluation was indicated.

Aim To evaluate the current referral process and dental care provided before patients receive HSCT.

Method Dental case notes were reviewed retrospectively for all patients who attended before allogeneic or autologous HSCT in the year 2016.

Results There appeared to be a positive engagement of both the medical team and patients with regards to referral for a pre-HSCT dental assessment. In addition, it was evident that this patient cohort did require dental treatment before HSCT with diagnoses of caries, periradicular infections and periodontal disease being made.

Conclusion Pre-HSCT dental assessment and treatment continues to be an important aspect of the medical pathway for this patient cohort. Developments to the care pathway and improvements in communication with the medical teams will help ensure the best-quality care is provided to the patients at the correct time. Future prospective studies are required to establish the overall benefit to patients of dental treatment before HSCT.

Key points

  • Discusses the indications for stem cell transplantation.

  • Discusses national guidance in relation to dental treatment to provide safe and effective dental care for this patient cohort.

  • Highlights the barriers to care that may be perceived for this patient cohort.

  • Details a service evaluation within a hospital department and how the results of this have allowed consideration for changes to practice to improve care for patients.

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Authors and Affiliations

  1. Academic Clinical Fellow Special Care Dentistry, Liverpool University Dental Hospital, UK

    Charlotte Wilson-Dewhurst

  2. Consultant in Special Care Dentistry, Liverpool University Dental Hospital, UK

    Andrew Kwasnicki & Avril Macpherson

  3. Professor/Honorary Consultant in Special Care Dentistry, Liverpool University Dental School, UK

    Shelagh Thompson

Authors
  1. Charlotte Wilson-Dewhurst
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  2. Andrew Kwasnicki
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  3. Avril Macpherson
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  4. Shelagh Thompson
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Correspondence to Charlotte Wilson-Dewhurst.

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Wilson-Dewhurst, C., Kwasnicki, A., Macpherson, A. et al. Dental treatment before haematopoietic stem cell transplantation - a service evaluation. Br Dent J (2021). https://doi.org/10.1038/s41415-021-2841-2

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