1985 Volume 31 Issue 4 Pages 898-908
Oral symptoms constitute one of the greatest sources of discomfort and potential danger in leukemia. Oral infection continues to be the leading cause of morbidity and mortality in patients with acute myeloblastic leukemia. The oral complication induced by inflammation gives the patients anguish. Further more, oral complication in patients who have undergone immunosuppressive and myelosuppressive treatment is reinforced. It is therefore crucial to eliminate oral sources of potential infection in these patients; toothbrushing, flossing and extractions (oral management) could be means of achieving this goal. Five cases involving the oral management of patients with acute leukemia (AML) are described. In all cases dental extraction (14 teeth) were performed (platelet; 1, 000-28, 000/mm3, leukocyte; 700-3, 800/mm3.). In one case pulpectomy (5 teeth) and in another cases plaque control (brushing and flossing) were performed.
The avoidence of dental extraction in these patients has generally been recommended.
However we feel that surgical procedures may be performed on patients with controlled disease and adequate management. No hemorrhagic complications occurred in any patients, and the temporary infection was managed with systemic antibiotics and oral irrigation.
The patients were carefully instructed in plaque control with the use of a tooth brush and dental floss and subgingival scaling.
Oral environment in all cases was improved. Because of the difficulty in treating oraldisease in leukemic persons while they are undergoing chemotherapy, it is extremely important that such patients have dental evaluations and, if possible, treatment prior to initiation of medical management for their neoplasia.
