What islLeukemia?
Leukemia is a cancer of the blood cells. The types of cells affected are the lymphocytes (white blood cells) and the myeloid cells (red/white blood cells and platelets).
How does leukemia affect the oral health of children?
Children with leukemia can have different oral manifestations. Knowing how to identify these may aid in the diagnosis of the condition or assessing its severity.
Oral manifestation of leukemia
- May present itself as chemotherapy-induced oral mucositis.
- Bacterial, fungal or viral oral infections. Opportunistic infections may arise as a result of immunosuppression.
- Oral bleeding such as, petechiae and gingival bleeding
Dental Management and Prevention
Prevention is essential in managing the dental health of the child with leukemia. Scheduling the child for early professional
dental examinations is recommended.
Tips for Proper Dental Hygiene
- Apply topical fluoride and visit the dentist every 6 months.
- Parents should begin brushing when the first baby tooth erupts and should assist their child in brushing until the child reaches 8 years of age.
- Use fluoridated toothpaste; for children under 3 years old use a smear amount of fluoridated toothpaste and for children above 4 years old use a pea size amount.
- Use a soft nylon toothbrush. If condition is moderate to severe use mild non-fluoridated toothpaste and foam brush.
- Sodium bicarbonate mouth rinses and mucosal covering agents might be recommended.
- Parents should monitor dietary practices (i.e. avoid prolonged use of bottle, reduce amounts of sugar consumed, reduce frequency of sugar consumed).
Preparing a Child with Leukemia for a Dental Appointment
Discuss the medications currently being taken with the child's dentist. A medical clearance from the oncologist or physician will be requested. Blood work might be requested to assess the child’s immune status and platelet count. Some children may need antibiotics prior to treatment. Additional measures might be recommended by your doctor depending on the child’s platelet count
Paula Miranda, DMD - Nicklaus Children's Pediatric Dentistry Residency Program
References
Surveillance, Epidemiology and End Results (SEER) Program, "Cancer Statistics Review." seer.cancer.gov. National Cancer Institute. 1975–2014.
"Cancer Facts & Figures." cancer.org. American Cancer Society. 2017.
"Guideline on Dental Management of Pediatric Patients Receiving Chemotherapy, Hematopoietic Cell Transplantation, and/or Radiation Therapy." aapd.org. American Academy of Pediatric Dentistry. 2013