Oral Manifestations: A Warning-Sign in Children with Hematological Disease Acute Lymphocytic Leukemia
Abstract
:1. Introduction
2. Oral Complications in Children with Acute Lymphoblastic Leukemia
- Primary complications, which occur mainly due to the disease itself; these result from the infiltration of malignant cells into oral structures, such as the gum and bone, and gingival edema or tooth pain due to pulp infiltration.
- Secondary complications are usually associated with a direct effect of radiation therapy or chemotherapy, such as thrombocytopenia, anemia and granulocytopenia. These include a tendency to bleed or susceptibility to infections.
- Tertiary complications usually occur due to the complex interactions of therapy and its side effects, such as immunosuppression. They include ulcerations, inflammation of the mucous membranes, osteoradionecrosis, xerostomia, taste alterations, trismus or carious lesions [26].
2.1. Mucositis
2.2. Xerostomia
2.3. Dysgeusia
2.4. Gingivitis and Gingival Bleeding
2.5. Caries
2.6. Trismus
2.7. Candida and Other Infections
2.8. Osteoradionecrosis
2.9. Oral Dysesthesia
2.10. Dental Developmental Disorders
3. Dental Care and Management of the Child Patient
3.1. Before Chemotherapy
- (a)
- To identify and stabilize or eliminate possible sources of infection and local irritants in the oral cavity in order to avoid delaying cancer treatment or inducing other complications. Any existing lesions that might normally lie dormant can flare up and become life threatening once the child is immunosuppressed.
- (b)
- To educate patients and parents about the importance of optimal oral care to minimize oral problems and discomfort before, during and after cancer treatment.
- (c)
3.2. During Chemotherapy
- (a)
- To maintain optimal oral health during cancer therapy.
- (b)
- To manage any oral side effects that may develop because of the cancer therapy.
- (c)
3.3. After Chemotherapy
- (a)
- To maintain optimal oral health.
- (b)
- To reinforce the importance of optimal oral and dental care for life to the patient/parents [66].
4. Concluding Remarks
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
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Soares, S.C.; Roux, L.J.D.; Castro, A.R.; Silva, C.C.; Rodrigues, R.; Macho, V.M.P.; Silva, F.; Costa, C. Oral Manifestations: A Warning-Sign in Children with Hematological Disease Acute Lymphocytic Leukemia. Hematol. Rep. 2023, 15, 491-502. https://doi.org/10.3390/hematolrep15030051
Soares SC, Roux LJD, Castro AR, Silva CC, Rodrigues R, Macho VMP, Silva F, Costa C. Oral Manifestations: A Warning-Sign in Children with Hematological Disease Acute Lymphocytic Leukemia. Hematology Reports. 2023; 15(3):491-502. https://doi.org/10.3390/hematolrep15030051
Chicago/Turabian StyleSoares, Sandra Clara, Louis J. D. Roux, Ana Rita Castro, Cristina Cardoso Silva, Rita Rodrigues, Viviana M. P. Macho, Fátima Silva, and Céu Costa. 2023. "Oral Manifestations: A Warning-Sign in Children with Hematological Disease Acute Lymphocytic Leukemia" Hematology Reports 15, no. 3: 491-502. https://doi.org/10.3390/hematolrep15030051