Oral health status and quality of life in female patients receiving low dose bone-modifying agents for cancer treatment-induced bone loss: a single-center exploratory study

TL;DR

This study explores oral health and quality of life in breast cancer patients on low-dose bone drugs, finding a low risk of a rare oral condition and suggesting the need for preventive dental care.

Contribution

The study is the first to explore oral health and quality of life in breast cancer patients on low-dose bone-modifying agents for cancer treatment-induced bone loss.

Findings

No cases of MRONJ were observed in patients receiving low-dose bone-modifying agents.

Longer treatment duration may be associated with a perceived reduction in oral well-being.

Patients showed moderate-to-severe periodontal involvement regardless of treatment duration.

Abstract

Breast cancer patients, undergoing low-dose bone-modifying agent (LD-BMA) therapy for cancer treatment-induced bone loss (CTIBL), represent an emerging category at risk of Medication-Related (MRONJ) low (<1%) but not absent. However, data on their oral health status and quality of life related are currently limited. This single-center exploratory study aimed to assess oral health conditions, periodontal status, and oral health-related quality of life in non-metastatic breast cancer patients under LD-BMA therapy for CTIBL.

Forty patients were consecutively and unselectively enrolled and divided into two groups based on the duration of LD-BMA therapy (<3 years vs. ≥3 years). Oral examination by decayed-missing-filled teeth index (DMFT) and Periodontal Screening and Recording (PSR) was performed, and the OHIP-14 questionnaire was administered to assess their oral health-related quality of life.

No statistically significant differences were observed between the two groups in PSR, DMFT, or OHIP-14 scores. PSR scores indicating moderate-to-severe periodontal involvement (3–4) were reported in 73.3% of patients treated for <3 years and 70% of those treated ≥3 years. Mean DMFT values were 9.7 and 12.0, respectively. Although patients treated for ≥3 years reported higher OHIP-14 scores, this trend did not reach statistical significance. No cases of MRONJ were observed in the study groups.

Patients affected by breast cancer receiving LD-BMA therapy for CTIBL and recruited in a preventive program appear to have a very low risk of MRONJ. Despite comparable clinical findings across treatment durations, longer LD-BMA therapy may be associated with a perceived reduction in oral well-being, possibly related to systemic and psychosocial burdens. These findings, with the limitation of a small sample size, support the implementation of individualized, risk-based dental and psychological preventive strategies, and reinforce the relevance of long-term dental surveillance in this under-explored population.

Figures