{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T18:19:27Z","timestamp":1790965167854,"version":"4.1.0"},"reference-count":46,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2023,5,18]],"date-time":"2023-05-18T00:00:00Z","timestamp":1684368000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Stiftelsen Wilhelm och Martina Lundgrens Vetenskapsfond","award":["2020-3569"],"award-info":[{"award-number":["2020-3569"]}]},{"name":"The Local Research and Development Council for Gothenburg and S\u00f6dra Bohusl\u00e4n Region V\u00e4stra G\u00f6taland","award":["VGFOUGSB-932842"],"award-info":[{"award-number":["VGFOUGSB-932842"]}]},{"DOI":"10.13039\/501100004622","name":"The Dutch Cancer Society","doi-asserted-by":"crossref","award":["ACTA 2014-7468"],"award-info":[{"award-number":["ACTA 2014-7468"]}],"id":[{"id":"10.13039\/501100004622","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100005293","name":"G\u00f6teborgs Tandl\u00e4kare-S\u00e4llskap","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005293","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005009","name":"Stiftelsen Assar Gabrielssons Fond","doi-asserted-by":"publisher","award":["FB 20-23 and FB 21-55"],"award-info":[{"award-number":["FB 20-23 and FB 21-55"]}],"id":[{"id":"10.13039\/501100005009","id-type":"DOI","asserted-by":"publisher"}]},{"name":"The Public Dental Health Organisation in V\u00e4rmland Region"},{"name":"TUA Research Funding University of Gothenburg Region V\u00e4stra G\u00f6taland","award":["TUAGBG-135781"],"award-info":[{"award-number":["TUAGBG-135781"]}]},{"name":"Internal funding from Atrium Health Carolinas Medical Center, Charlotte, NC,"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Despite advances in transplant medicine, prevalence of complications after hematopoietic stem cell transplantation (HSCT) remains high. The impact of pre-HSCT oral health factors on the incidence and severity of complications post-HSCT is poorly understood. The aim of this prospective, observational study was to analyze oral health in patients planned for HSCT. Patients \u226518 years requiring HSCT were included from five sites between 2011\u20132018. General health, oral findings and patient-reported symptoms were registered in 272 patients. Oral symptoms around disease onset were reported by 43 patients (15.9%) and 153 patients (58.8%) reported oral complications during previous chemotherapy. One third of patients experienced oral symptoms at the oral examination before conditioning regimen and HSCT. In total, 124 (46.1%) patients had dental caries, 63 (29.0%) had \u2265one tooth with deep periodontal pockets, 147 (75.0%) had \u2265one tooth with bleeding on probing. Apical periodontitis was observed in almost 1\/4 and partially impacted teeth in 17 (6.3%) patients. Oral mucosal lesions were observed in 84 patients (30.9%). A total of 45 (17.4%) of 259 patients had at least one acute issue to be managed prior to HSCT. In conclusion, oral symptoms and manifestations of oral disease were prevalent in patients planned for HSCT. The extent of oral and acute dental diseases calls for general oral screening of patients pre-HSCT.<\/jats:p>","DOI":"10.1371\/journal.pone.0285615","type":"journal-article","created":{"date-parts":[[2023,5,18]],"date-time":"2023-05-18T13:36:39Z","timestamp":1684416999000},"page":"e0285615","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":24,"title":["Oral health in patients scheduled for hematopoietic stem cell transplantation in the Orastem study"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7377-4208","authenticated-orcid":true,"given":"Kristina","family":"Skallsj\u00f6","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5509-4954","authenticated-orcid":true,"given":"Inger","family":"von B\u00fcltzingsl\u00f6wen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bengt","family":"Hass\u00e9us","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan-Erik","family":"Johansson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenny","family":"\u00d6hman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith E.","family":"Raber-Durlacher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Charlotte D. N. J. M.","family":"Huysmans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1291-2798","authenticated-orcid":true,"given":"Alexa M. G. A.","family":"Laheij","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4522-3705","authenticated-orcid":true,"given":"Stephanie J. M.","family":"van Leeuwen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan J.","family":"Hovan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Garming Legert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hieu M.","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip J.","family":"Turk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8196-8811","authenticated-orcid":true,"given":"Frederik R.","family":"Rozema","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1801-2072","authenticated-orcid":true,"given":"Nicole M. A.","family":"Blijlevens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0638-4335","authenticated-orcid":true,"given":"Michael T.","family":"Brennan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,5,18]]},"reference":[{"key":"pone.0285615.ref001","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1016\/S1470-2045(03)01218-X","article-title":"Infections in patients with cancer undergoing chemotherapy: aetiology, prevention, and treatment.","volume":"4","author":"S Vento","year":"2003","journal-title":"Lancet Oncol."},{"key":"pone.0285615.ref002","doi-asserted-by":"crossref","first-page":"e606","DOI":"10.1016\/S1470-2045(14)70344-4","article-title":"Infection control issues in patients with haematological malignancies in the era of multidrug-resistant bacteria","volume":"15","author":"M Ruhnke","year":"2014","journal-title":"Lancet Oncol"},{"key":"pone.0285615.ref003","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1016\/j.tripleo.2008.12.006","article-title":"Advances in hematologic stem cell transplant: an update for oral health care providers","volume":"107","author":"JB Epstein","year":"2009","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol Endod"},{"key":"pone.0285615.ref004","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1159\/000487085","article-title":"Burden of Oral Mucositis: A Systematic Review and Implications for Future Research.","volume":"41","author":"K Berger","year":"2018","journal-title":"Oncol Res Treat."},{"key":"pone.0285615.ref005","doi-asserted-by":"crossref","first-page":"400","DOI":"10.3322\/caac.21157","article-title":"Oral complications of cancer and cancer therapy: from cancer treatment to survivorship","volume":"62","author":"JB Epstein","year":"2012","journal-title":"CA Cancer J Clin"},{"key":"pone.0285615.ref006","doi-asserted-by":"crossref","first-page":"378281","DOI":"10.1155\/2014\/378281","article-title":"Oral complications in hematopoietic stem cell recipients: the role of inflammation","volume":"2014","author":"TM Haverman","year":"2014","journal-title":"Mediators Inflamm"},{"key":"pone.0285615.ref007","doi-asserted-by":"crossref","first-page":"219","DOI":"10.3816\/SCT.2004.n.014","article-title":"Oral complications and management considerations in patients treated with high-dose chemotherapy","volume":"1","author":"JE Raber-Durlacher","year":"2004","journal-title":"Support Cancer Ther"},{"key":"pone.0285615.ref008","doi-asserted-by":"crossref","first-page":"2026","DOI":"10.1002\/cncr.20163","article-title":"Clinical practice guidelines for the prevention and treatment of cancer therapy-induced oral and gastrointestinal mucositis","volume":"100","author":"EB Rubenstein","year":"2004","journal-title":"Cancer"},{"key":"pone.0285615.ref009","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1034\/j.1399-302X.2003.00075.x","article-title":"Oral and intestinal microflora in 5-fluorouracil treated rats, translocation to cervical and mesenteric lymph nodes and effects of probiotic bacteria","volume":"18","author":"I Von B\u00fcltzingsl\u00f6wen","year":"2003","journal-title":"Oral Microbiol Immunol"},{"key":"pone.0285615.ref010","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1016\/S1368-8375(01)00009-4","article-title":"5-Fluorouracil induces autophagic degeneration in rat oral keratinocytes","volume":"37","author":"I von B\u00fcltzingsl\u00f6wen","year":"2001","journal-title":"Oral Oncol"},{"key":"pone.0285615.ref011","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.oraloncology.2006.12.006","article-title":"A decision analysis: the dental management of patients prior to hematology cytotoxic therapy or hematopoietic stem cell transplantation","volume":"44","author":"S Elad","year":"2008","journal-title":"Oral Oncol"},{"key":"pone.0285615.ref012","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1038\/sj.bmt.1702818","article-title":"Dental health and viridans streptococcal bacteremia in allogeneic hematopoietic stem cell transplant recipients","volume":"27","author":"CJ Graber","year":"2001","journal-title":"Bone Marrow Transplant"},{"key":"pone.0285615.ref013","doi-asserted-by":"crossref","first-page":"1621","DOI":"10.1007\/s00520-012-1706-2","article-title":"Periodontal status and bacteremia with oral viridans streptococci and coagulase negative staphylococci in allogeneic hematopoietic stem cell transplantation recipients: a prospective observational study","volume":"21","author":"JE Raber-Durlacher","year":"2013","journal-title":"Support Care Cancer"},{"key":"pone.0285615.ref014","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1007\/s00520-017-3829-y","article-title":"A systematic review of dental disease management in cancer patients","volume":"26","author":"CHL Hong","year":"2018","journal-title":"Support Care Cancer"},{"key":"pone.0285615.ref015","article-title":"Apical periodontitis as potential source of infection in patients with lymphoma treated with chemotherapy.","author":"K Skallsjo","year":"2019","journal-title":"Clin Oral Investig."},{"key":"pone.0285615.ref016","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1111\/odi.13329","article-title":"Should oral foci of infection be removed before the onset of radiotherapy or chemotherapy","volume":"27","author":"FKL Spijkervet","year":"2021","journal-title":"Oral Dis"},{"key":"pone.0285615.ref017","doi-asserted-by":"crossref","first-page":"2231","DOI":"10.1007\/s00520-020-05733-1","article-title":"Dental status and risk of odontogenic complication in patients undergoing hematopoietic stem cell transplant","volume":"29","author":"HJ Hansen","year":"2021","journal-title":"Support Care Cancer"},{"key":"pone.0285615.ref018","doi-asserted-by":"crossref","first-page":"E19","DOI":"10.1038\/sj.bdj.2009.304","article-title":"Dental assessment prior to stem cell transplant: treatment need and barriers to care","volume":"206","author":"K Durey","year":"2009","journal-title":"Br Dent J"},{"key":"pone.0285615.ref019","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1007\/s00520-003-0499-8","article-title":"Time limitations and the challenge of providing infection-preventing dental care to hematopoietic stem-cell transplantation patients","volume":"11","author":"S Elad","year":"2003","journal-title":"Support Care Cancer"},{"key":"pone.0285615.ref020","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1067\/moe.2001.113588","article-title":"Sequelae and complications related to dental extractions in patients with hematologic malignancies and the impact on medical outcome","volume":"92","author":"A Raut","year":"2001","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol Endod"},{"key":"pone.0285615.ref021","doi-asserted-by":"crossref","first-page":"979","DOI":"10.1007\/s00520-010-0856-3","article-title":"Systematic reviews of oral complications from cancer therapies, Oral Care Study Group, MASCC\/ISOO: methodology and quality of the literature.","volume":"18","author":"MT Brennan","year":"2010","journal-title":"Support Care Cancer."},{"key":"pone.0285615.ref022","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1002\/cncr.28592","article-title":"MASCC\/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy","volume":"120","author":"RV Lalla","year":"2014","journal-title":"Cancer"},{"key":"pone.0285615.ref023","doi-asserted-by":"crossref","first-page":"e103","DOI":"10.2196\/resprot.8982","article-title":"Impact of Oral Side Effects from Conditioning Therapy Before Hematopoietic Stem Cell Transplantation: Protocol for a Multicenter Study.","volume":"7","author":"MT Brennan","year":"2018","journal-title":"JMIR Res Protoc"},{"key":"pone.0285615.ref024","first-page":"121","article-title":"Periodontal Disease in Pregnancy II.","volume":"22","author":"J Silness","year":"1964","journal-title":"Correlation Between Oral Hygiene and Periodontal Condition. Acta Odontologica Scandinavica"},{"key":"pone.0285615.ref025","volume-title":"WHO handbook for reporting results of cancer treatment.","author":"World Health Organization","year":"1979"},{"key":"pone.0285615.ref026","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.tripleo.2004.01.009","article-title":"MedView: an instrument for clinical research and education in oral medicine","volume":"99","author":"M Jontell","year":"2005","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol Endod"},{"key":"pone.0285615.ref027","volume-title":"R: A language and environment for statistical computing","author":"R Core Team","year":"2020"},{"key":"pone.0285615.ref028","doi-asserted-by":"crossref","first-page":"e766","DOI":"10.4317\/medoral.19286","article-title":"The morbidity of oral mucosal lesions in an adult Swedish population.","volume":"18","author":"J Robledo-Sierra","year":"2013","journal-title":"Med Oral Patol Oral Cir Bucal"},{"key":"pone.0285615.ref029","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1007\/s00784-017-2127-x","article-title":"Oral health status in adult patients with newly diagnosed acute leukemia","volume":"22","author":"R Busjan","year":"2018","journal-title":"Clin Oral Investig"},{"key":"pone.0285615.ref030","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1016\/j.adaj.2018.01.019","article-title":"Prevalence of oral lesions in and dental needs of patients with newly diagnosed acute leukemia","volume":"149","author":"E Watson","year":"2018","journal-title":"J Am Dent Assoc"},{"key":"pone.0285615.ref031","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1067\/moe.2001.116506","article-title":"Oral manifestations in patients with aplastic anemia","volume":"92","author":"MT Brennan","year":"2001","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol Endod"},{"key":"pone.0285615.ref032","doi-asserted-by":"crossref","first-page":"3479","DOI":"10.1007\/s00520-019-4650-6","article-title":"Prevalence of oral side effects of chemotherapy and its relationship with periodontal risk: a cross sectional study","volume":"27","author":"B Garc\u00eda-Ch\u00edas","year":"2019","journal-title":"Support Care Cancer"},{"key":"pone.0285615.ref033","doi-asserted-by":"crossref","first-page":"1141","DOI":"10.1007\/s00520-019-04921-y","article-title":"The prevalence of patient-reported dysphagia and oral complications in cancer patients","volume":"28","author":"J Frowen","year":"2020","journal-title":"Support Care Cancer"},{"key":"pone.0285615.ref034","doi-asserted-by":"crossref","first-page":"468","DOI":"10.14219\/jada.archive.1978.0304","article-title":"Oral complications in patients receiving treatment for malignancies other than of the head and neck.","volume":"97","author":"ST Sonis","year":"1978","journal-title":"J Am Dent Assoc"},{"key":"pone.0285615.ref035","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1007\/s00520-010-0827-8","article-title":"A systematic review of salivary gland hypofunction and xerostomia induced by cancer therapies: prevalence, severity and impact on quality of life.","volume":"18","author":"SB Jensen","year":"2010","journal-title":"Support Care Cancer."},{"key":"pone.0285615.ref036","doi-asserted-by":"crossref","first-page":"3085","DOI":"10.1007\/s00784-019-03178-3","article-title":"Oral disorders in patients with newly diagnosed haematological diseases.","volume":"24","author":"U Pauliina","year":"2020","journal-title":"Clin Oral Investig"},{"key":"pone.0285615.ref037","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1111\/ejh.13209","article-title":"Common oral diseases in allogeneic haematopoietic stem cell transplantation (HSCT) recipients pre-HSCT.","volume":"102","author":"P Uutela","year":"2019","journal-title":"Eur J Haematol"},{"key":"pone.0285615.ref038","doi-asserted-by":"crossref","first-page":"972","DOI":"10.1038\/bjc.2016.60","article-title":"Effect of leaving chronic oral foci untreated on infectious complications during intensive chemotherapy","volume":"114","author":"JM Schuurhuis","year":"2016","journal-title":"Br J Cancer"},{"key":"pone.0285615.ref039","doi-asserted-by":"crossref","first-page":"3949","DOI":"10.1007\/s00520-019-04848-4","article-title":"Systematic review of basic oral care for the management of oral mucositis in cancer patients and clinical practice guidelines","volume":"27","author":"CHL Hong","year":"2019","journal-title":"Support Care Cancer"},{"key":"pone.0285615.ref040","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1177\/0022034514561768","article-title":"Prospective study of dental intervention for hematopoietic malignancy","volume":"94","author":"K Tsuji","year":"2015","journal-title":"J Dent Res"},{"key":"pone.0285615.ref041","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1007\/s00520-005-0867-7","article-title":"Mucositis prevention by improved dental care in acute leukemia patients","volume":"14","author":"M Djuric","year":"2006","journal-title":"Support Care Cancer"},{"key":"pone.0285615.ref042","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1007\/s00520-011-1116-x","article-title":"Professional oral health care reduces oral mucositis and febrile neutropenia in patients treated with allogeneic bone marrow transplantation","volume":"20","author":"H Kashiwazaki","year":"2012","journal-title":"Support Care Cancer"},{"key":"pone.0285615.ref043","doi-asserted-by":"crossref","first-page":"911","DOI":"10.7314\/APJCP.2016.17.3.911","article-title":"Leukemic Oral Manifestations and their Management","volume":"17","author":"CF Francisconi","year":"2016","journal-title":"Asian Pac J Cancer Prev"},{"key":"pone.0285615.ref044","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.1007\/s00520-010-0902-1","article-title":"A systematic review of dysgeusia induced by cancer therapies","volume":"18","author":"AJ Hovan","year":"2010","journal-title":"Support Care Cancer"},{"key":"pone.0285615.ref045","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1007\/s005200000214","article-title":"Oral status during radiotherapy and chemotherapy: a descriptive study of patient experiences and the occurrence of oral complications","volume":"9","author":"KE Ohrn","year":"2001","journal-title":"Support Care Cancer"},{"key":"pone.0285615.ref046","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1007\/s00784-016-1760-0","article-title":"Determinants of stimulated salivary flow among haematopoietic stem cell transplantation recipients","volume":"21","author":"M Mauramo","year":"2017","journal-title":"Clinical Oral Investigations"}],"updated-by":[{"DOI":"10.1371\/journal.pone.0345853","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000}}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0285615","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,18]],"date-time":"2023-05-18T13:37:36Z","timestamp":1684417056000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0285615"}},"subtitle":[],"editor":[{"given":"Gaetano","family":"Isola","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2023,5,18]]},"references-count":46,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2023,5,18]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0285615","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,18]]}}}