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The Dental Safety Profile of High-Dose Radioiodine Therapy for Thyroid Cancer: Long-Term Results of a Longitudinal Cohort Study

¹ Institute of Nuclear Medicine, University Hospital Basel, Basel, Switzerland; ² Clinic of Endocrinology, University Hospital Basel, Basel, Switzerland; ³ Institute of Social and Preventive Medicine, University of Basel, Basel, Switzerland; and ⁴ Institute of Public Dental Health, Basel, Switzerland

Correspondence: For correspondence or reprints contact: Martin A. Walter, MD, Institute of Nuclear Medicine and Division of Endocrinology, University Hospital, Petersgraben 4, CH-4031 Basel, Switzerland. E-mail: m.a.walter{at}gmx.net

The long-term dental safety profile of high-dose radioiodine therapy remained elusive despite more than 6 decades of clinical use. Methods: In a cohort study, we investigated the incidence of sialadenitis, xerostomia, caries, and tooth extractions after high-dose radioiodine therapy for differentiated thyroid cancer and explored risk factors by multiple regression models. Results: One hundred seventy-six participants were recruited (median follow-up, 6.6 y; range, 1.1–32.6 y; patient-years: 8,472 before and 1,421 after radioiodine therapy). Scintigraphic salivary gland uptake during radioiodine treatment predicted development of sialadenitis (odds ratio: 1.31 [1.05–1.63], P = 0.015) and xerostomia (odds ratio: 1.58 [1.16–2.16], P = 0.004). The caries risk increased by postradioiodine xerostomia (% increase: 98.8 [26.5–212], P = 0.003). The long-term risk for postradioiodine tooth extractions increased with increasing cumulative radioiodine activities (% increase [per gigabequerel]: 8.14 [1.07, 15.7], P = 0.02). Conclusion: High-dose radioiodine treatment can impair the long-term dental health, depending on the cumulative radioiodine activity and individual salivary gland radioiodine uptake.

^* Contributed equally to this work.

COPYRIGHT © 2007 by the Society of Nuclear Medicine, Inc.

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