Supportive Care in Cancer

, Volume 25, Issue 4, pp 1191–1199 | Cite as

Dental health status and patient-reported outcomes at baseline in patients participating in the osteonecrosis of the jaw registry study, SWOG S0702

  • Catherine H. Van PoznakEmail author
  • Amy Darke
  • Carol M. Moinpour
  • Robert A. Bagramian
  • Mark M. Schubert
  • Julie R. Gralow
  • James L. WadeIII
  • Joseph M. Unger
Original Article



SWOG S0702 was a cohort study of patients with cancer with bone metastases due to any cancer. Using baseline data from S0702, this report characterizes the oral health and oral health-related quality of life (OHRQoL) of patients with advanced cancer.


S0702 case report forms captured dental assessment and patient-reported outcome (PRO) data. This analysis compares PRO dental discomfort with selected clinical assessments of dental health. This analysis focuses on the 2294 patients who underwent baseline dental examination prior to study registration, but also reports on the 1235 patients for whom only OHRQol data are available. Dental characteristics including the number of teeth and the presence of gingivitis and periodontal disease were examined for correlation with PRO of oral pain, interference with eating, smiling, speech, or quality of life.


The median age of the study participants was 62. Greater than 60% of the 2294 patients with baseline dental assessments had none to mild plaque, calculus, gingivitis, or periodontal disease, suggesting that most of this cohort had good oral hygiene. However, in each of these same categories, approximately 6% had dental findings classified as severe conditions (poor oral hygiene). There was strong evidence that the presence of periodontal disease, gingivitis, and number of teeth was correlated with lower OHRQoL across multiple domains, including pain (mouth or jaw), interference with eating, smiling and speech, and overall quality of life.


This report characterizes the oral health and OHRQoL of patients with advanced bone metastases receiving palliative therapy.

Trial registration Identifier: NCT00874211


Oral health Cancer Bone metastases Patient-reported outcomes 



Danika L. Lew, MD, provided statistical assistance; Lisa Hansen, RN, MS, provided clinical input; and Kimberly Kaberle and Diane Liggett, BS, were responsible for protocol coordination and data management.

No compensation was received beyond their salary for this work.

Compliance with ethical standards

The participating sites obtained institutional review board approval. Informed, written consent was obtained from all patients prior to enrollment.

Conflict of interest

The authors declare that they have no conflicts of interest. SWOG and the authors have full control of the primary data. We agree to allow the journal to review aggregate level data, if requested.


Funding for this work was provided National Institutes of Health, National Cancer Institute, NCI Community Oncology Research Program (NCORP) Research Base grant, 5UG1CA189974.

Supplementary material

520_2016_3509_MOESM1_ESM.pdf (306 kb)
ESM 1 (PDF 305 kb)


  1. 1.
    Siegel RL, Miller KD, Jemal A (2016) Cancer statistics, 2016. CA Cancer J Clin 66(1):7–30Google Scholar
  2. 2.
    Coleman RE (2001) Metastatic bone disease: clinical features, pathophysiology and treatment strategies. Cancer Treat Rev 27(3):165–176CrossRefGoogle Scholar
  3. 3.
    Li S, Peng U, Weinhandl ED, et. al. Estim.ated numbe.r of prevalent case.s of meta.static bone disease in the US adult po.pulation Clinical Epidemiology 2012:4 87–93Google Scholar
  4. 4.
    World Health Organization Accessed 31 May 2016
  5. 5.
    Smith TJ, Temin S, Alesi ER et al (2012) American Society of Clinical Oncology provisional clinical opinion: the integration of palliative care into standard oncology care. J Clin Oncol 30(8):880–887CrossRefGoogle Scholar
  6. 6.
    Sischo L, Broder HL (2011) Oral health-related quality of life: what, why, how, and future implications. Critical Reviews in Oral Biology & Medicine 90(11):1264–1270Google Scholar
  7. 7.
    Bennadi D, Reddy CVK (2013) Oral health related quality of life. Journal of international Society of Preventive & Community Dentistry 3(1):1–6CrossRefGoogle Scholar
  8. 8.
    Cleeland CS, Ryan KM (1994) Pain assessment: global use of the brief pain inventory. Ann Acad Med Singap 23(2):129–138PubMedGoogle Scholar
  9. 9.
    Farrar JT, Young JP Jr, LaMoreaux L, Werth JL, Poole RM (2001) Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain 94(2):149–158CrossRefGoogle Scholar
  10. 10.
    Eke PI, Zhang X, Lu H et al (2016) Predicting periodontitis at state and local levels in the United States. J Dent Res 95(5):515–522CrossRefGoogle Scholar
  11. 11.
    U.S. Department of Health and Human Services. Oral health in America: a report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institutes of Health, 2000.Google Scholar
  12. 12.
    Center for Disease Control and Prevention; oral and dental health.
  13. 13.
    American Dental Association guidelines; update and recommendations. American Dental Association Council on Scientific Affairs (2006) J Am Dent Assoc 137:1304–1312CrossRefGoogle Scholar
  14. 14.
    Unger JM, Hershman DL, Albain KS, Moinpour CM, Petersen JA, Burg K, Crowley JJ (2013) Patient income level and cancer clinical trial participation. J Clin Oncol 31(5):536–542. doi: 10.1200/JCO.2012.45.4553 CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Unger JM, Gralow JR, Albain KS, Ramsey SD, Hershman DL (2016) Patient income level and cancer clinical trial participation: a prospective survey study. JAMA Oncol 2(1):137–139CrossRefGoogle Scholar
  16. 16.
    American Dental Association
  17. 17.
    Center for Disease Control and Prevention; oral health for adults accessed 5-31-2016

Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Catherine H. Van Poznak
    • 1
    Email author
  • Amy Darke
    • 2
  • Carol M. Moinpour
    • 3
  • Robert A. Bagramian
    • 4
  • Mark M. Schubert
    • 5
  • Julie R. Gralow
    • 6
  • James L. WadeIII
    • 7
  • Joseph M. Unger
    • 2
  1. 1.University of MichiganAnn ArborUSA
  2. 2.SWOG Statistical Center, Fred Hutchinson Cancer CenterSeattleUSA
  3. 3.Fred Hutchinson Cancer CenterUniversity of WashingtonSeattleUSA
  4. 4.School of DentistryUniversity of MichiganAnn ArborUSA
  5. 5.School of DentistryUniversity of WashingtonSeattleUSA
  6. 6.University of WashingtonSeattleUSA
  7. 7.Heartland NCORP/Cancer Care Specialists of Central IllinoisDecaturUSA

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