Oral manifestations and dental management in patients undergoing CAR-T cell therapy: a retrospective observational study

Chimeric antigen receptor T-cell (CAR-T) therapy has emerged as a highly effective treatment for refractory and relapsed hematologic malignancies. Despite its clinical benefits, CAR-T therapy is associated with a unique toxicity profile, including cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS), and prolonged immunosuppression. Oral complications in this population remain underreported. This retrospective case series was aimed at describing oral manifestations and dental management in patients undergoing CAR-T therapy at a tertiary referral center. Medical and dental records of ten patients treated with CAR-T therapy between 2024 and 2025 were reviewed. Demographic data, underlying hematologic diagnoses, CAR-T-related toxicities, and oral findings were analyzed descriptively. The main oral manifestations observed were xerostomia, opportunistic infections, dental pain, and dysgeusia. Oral care focused on symptom control, prevention of secondary infections, and supportive oral management during periods of severe immunosuppression. These findings suggest that early dental involvement may contribute to supportive care strategies, particularly for the detection and management of opportunistic infections and dental infectious foci in neutropenic patients. Standardized oral assessment protocols and preventive dental measures may contribute to supportive clinical management and symptom monitoring in this patient population.