The frequency of oral conditions detected in hematology inpatients

Abstract

BackgroundOral manifestations may be the first signs of hematologic diseases, and may occur due to the disease itself or to treatment.ObjectiveTo evaluate the frequency and types of oral conditions presented by patients on a hematology ward.MethodsData were collected by oral examinations during weekly visits to a hematology ward. Six trained dentists performed the oral assessment based on the principles of oral semiology. All patients who accepted to be examined were included in the study. Patients who were unavailable or unable to have oral examinations were excluded. Data were recorded on protocol forms and in the electronic records of the institution. A descriptive analysis was performed.ResultsSeventy-nine patients were included in the analysis; 50.6% were female and the mean age was 41.49 years. The most common reasons for hospitalization were chemotherapy and complications (81%), relapse (13.9%) and pre-transplant preparation (5%). The most frequent underlying diseases were multiple myeloma (17.7%), acute myeloid leukemia (15.4%) and acute lymphocytic leukemia (11.5%). Oral conditions were found in 36 (45.6%) patients, some of whom presented more than one condition. The most common oral conditions were dry lips (12.6%), mucositis (10.1%), petechiae (8.9%) and candidiasis (7.6%). Of the detected oral conditions, 56.9% were related to the underlying disease or chemotherapy and 20.2% were not related to the disease.ConclusionThis study shows the types and frequency of oral conditions observed in hematological inpatients. Awareness of these conditions is important for prevention and planning the care of patients with hematological diseases.

Oral Manifestations and Complications in Childhood Acute Myeloid Leukemia

“…Oral lesions, especially gingival hyperplasia, may be the first signs of hematologic diseases. Therefore, oral health-care professionals should be aware of the oral manifestations in AML, and of the importance of detecting the signs related of this systemic condition that often compel the patient to seek for dental care first [44]. To establish an early diagnosis and subsequent management, the dental practitioner must clearly recognize these alterations and investigate them with additional tests and further refer the patient to a specialized center [4].…”

“…Moreover, oral health can be maintained with cooperation between pediatricians, pediatric oncohematologists, hematologists, dental surgeons, and dental hygienists [ 28 ]. The role of the dentist in a multidisciplinary team is essential also for prevention, diagnosis, and control of preexisting problems such as tooth decay, periodontal diseases and other alterations of the oral and perioral tissues [ 44 ]. In particular, as recommended by the Children’s Oncology Group Guidelines ( ), dental examination should be performed twice yearly as part of the medical follow-up by monitoring late effects in long-term survivors of childhood cancer carried out by a dental surgeon experienced in survivorship care.…”

“…Dentists play an important role in detecting oral signs which are suspicious or diagnostic of leukemia in early stages during inpatient or outpatient consultation, and subsequently in referring cases to hematologists for hematological examination. Patients should also be referred to the Oral Health Program clinic where imaging, precision periodontal instruments, or any other auxiliary methods to evaluate oral tissue are available [44]. Dentists are part of the multidisciplinary team during the pre-treatment and post-treatment period of AML.…”

Assessment of Frequency of Oral Conditions in Patients with Hematological Malignancies: A Hospital-Based Study

“…Xerostomia and hyposalivation are frequent side effects of chemotherapy. 26 It was found from the literature that xerogenic drugs such as diuretics, antihypertensive and anti-histamine drugs were administered to the patients in this study. Dry lips found was may be aggravated due to use of air conditioning among hospital wards leading to dry environment.…”

Effect of zinc on oropharyngeal mucositis in children with acute leukemia undergoing chemotherapy

“…Patients who also present with neutropenia and thrombocytopenia have an increased risk of oral bleeding and infections, which can lead to septicemia ( 2 , 7 - 9 ). OM involves pain, difficulty in swallowing and speaking, malnutrition, functional status deterioration, longer hospital stay, increased economic costs and decreased quality of life ( 3 , 4 , 7 , 8 , 10 - 13 ). In the pathophysiology of OM, 5 phases have been described in which a variety of cells are involved ( 12 - 14 ).…”