Evaluation of periodontal health in breast cancer patients undergoing tamoxifen or aromatase inhibitors drugs therapy: A cross-sectional study

Original Research: Oral Health Concerns of Female Breast Cancer Survivors on Adjuvant Endocrine Therapy

BACKGROUND

Oral complications from cancer treatments are among the adverse effects breast cancer survivors can face. Yet such complications are often overlooked in cancer survivorship care. Many breast cancer survivors are receiving adjuvant endocrine therapy, but there is limited understanding of potential oral complications from this therapy.

PURPOSE

This study aimed to compare aspects of oral health in female breast cancer survivors who were taking adjuvant endocrine therapy with those of survivors not taking such therapy.

METHODS

National Health and Nutrition Examination Survey data collected from January 2009 through March 2020 were used for the analysis. Female adults ages 20 years and older who had been diagnosed with breast cancer were included. Linear regression and χ 2 analyses were conducted to examine aspects of oral health, using IBM SPSS Complex Samples software, version 27.

RESULTS

In our sample of 423 female breast cancer survivors, 7.1% were taking tamoxifen, 7.8% were taking anastrozole, 4.3% were taking letrozole, and 2.9% were taking exemestane. Compared with the survivors not taking such therapy, a greater proportion of those taking it had decayed teeth, gum disease/problems, and were recommended for imminent dental care after oral health examination by dentists. The survivors who were not taking adjuvant endocrine therapy had more coronal cavities.

CONCLUSIONS

Data analysis showed that female breast cancer survivors taking adjuvant endocrine therapy appear more likely to have oral health issues than those not taking such therapy. Improved awareness of these issues is critical. Assessment and management guidelines to address these oral health issues are needed by health care providers.

Association between tamoxifen and tooth loss in women with breast cancer

OBJECTIVES

Investigate the effect of tamoxifen on the occurrence of tooth loss (TL) in breast cancer (BC) survivors.

METHODS

A cross-sectional study was conducted with 140 BC survivors using tamoxifen therapy. Sociodemographic, medical, and dental data were evaluated. TL was determined using the M component of the Decayed, Missing and Filled Teeth (DMFT) index. Logistic regression models were run to determine associations between the independent variables and outcome (TL).

RESULTS

Mean TL was 12.96 (SD 8.88). Only three participants had lost no teeth and 10.7% were completely edentulous. Participants who used tamoxifen for more than 1 year had a higher mean missing teeth (13.99 vs. 10.45; P = 0.030). After the adjustments, the occurrence of more than 12 missing teeth was 2.75-fold higher among women who used tamoxifen for more than 1 year (95% CI: 1.06-7.12). Moreover, age over 65 years, referral for treatment by the public healthcare system, less use of dental services, xerostomia, and a lower occurrence of dental caries remained associated with the loss of more than 12 teeth.

CONCLUSION

Longer use of tamoxifen was associated with greater tooth loss in breast cancer survivors.

CLINICAL RELEVANCE

Based on estimates of the increase in cases of breast cancer, the prolonged use of tamoxifen for the treatment of this disease can exert an impact on oral health through the occurrence of tooth loss. These findings can contribute to the planning and implementation of oral health care and prevention strategies for such patients.