Book contents
- Frontmatter
- Contents
- Acknowledgments
- Contributor
- 1 Rationale for transplantation
- 2 Types of transplantation
- 3 Human leukocyte antigen matching in allogeneic transplantation
- 4 Stem cell source
- 5 Pretransplant evaluation and counseling of patient and donor
- 6 Conditioning regimens
- 7 Stem cell infusion
- 8 ABO compatibility
- 9 Engraftment
- 10 Preventative care
- 11 Transplant-related complications
- 12 Overview of acute and chronic graft-versus-host disease
- 13 Acute graft-versus-host disease and staging
- 14 Graft-versus-host disease prophylactic regimens
- 15 Treatment guidelines for acute graft-versus-host disease
- 16 Chronic graft-versus-host disease
- 17 Engraftment syndrome
- 18 Infectious disease
- 19 Graft rejection and failure
- 20 Gastrointestinal complications
- 21 Oral health in stem cell transplantation
- 22 Pulmonary complications
- 23 Veno-occlusive disease
- 24 Special transfusion-related situations
- 25 Cardiovascular complications
- 26 Neurologic complications
- 27 Cystitis
- 28 Donor lymphocyte infusion
- 29 Transplantation: regulation and accreditation
- Index
21 - Oral health in stem cell transplantation
Published online by Cambridge University Press: 05 November 2013
- Frontmatter
- Contents
- Acknowledgments
- Contributor
- 1 Rationale for transplantation
- 2 Types of transplantation
- 3 Human leukocyte antigen matching in allogeneic transplantation
- 4 Stem cell source
- 5 Pretransplant evaluation and counseling of patient and donor
- 6 Conditioning regimens
- 7 Stem cell infusion
- 8 ABO compatibility
- 9 Engraftment
- 10 Preventative care
- 11 Transplant-related complications
- 12 Overview of acute and chronic graft-versus-host disease
- 13 Acute graft-versus-host disease and staging
- 14 Graft-versus-host disease prophylactic regimens
- 15 Treatment guidelines for acute graft-versus-host disease
- 16 Chronic graft-versus-host disease
- 17 Engraftment syndrome
- 18 Infectious disease
- 19 Graft rejection and failure
- 20 Gastrointestinal complications
- 21 Oral health in stem cell transplantation
- 22 Pulmonary complications
- 23 Veno-occlusive disease
- 24 Special transfusion-related situations
- 25 Cardiovascular complications
- 26 Neurologic complications
- 27 Cystitis
- 28 Donor lymphocyte infusion
- 29 Transplantation: regulation and accreditation
- Index
Summary
Introduction
The oral cavity is a frequentsite of infectious and noninfectious complications during and after stemcell transplantation. Good dental hygiene before and after HSCT isimportant. Risk of developing complications is dependent on a number offactors, including pretransplant dental health, HSV seropositivity, age,graft source, conditioning regimen intensity, development ofgraft-versus-host disease (GVHD), and the need for long-termimmunosuppressive therapy. Patients should be routinely monitored for oralcavity changes and symptoms at all stages of transplantation.Transplantation programs can benefit greatly from the inclusion of oralmedicine as part of the care team, in particular for diagnosis andmanagement of patients with oral conditions of unclear etiology, or forthose that do not respond to standard first-line therapies.
Pretransplant dental evaluation
The dentition is a potentialsource of infection during transplantation and prolonged periods of profoundimmunosuppression. In order to reduce risk, all patients should undergo acomprehensive dental evaluation by a dentist prior to transplantation. Theevaluation should consist of a full mouth series of intraoral radiographsand hard and soft tissue examination with special attention to caries,defective restorations, mobile teeth and teeth with deep pocketing(periodontal disease), third molars, and periapical pathology (Figures 21.1and 21.2). All patients should receive a dental prophylaxis and any teethwith caries should be treated. Sharp edges should be smoothed to reduce riskof soft tissue injury which might contribute to mucositis. Teeth withperiapical pathology require endodontic therapy or extraction. Third molarswith a prior history of pericoronitis (infection/swelling of surroundinggingiva) should be considered for extraction (Figure 21.3). The foregoinginformation is summarized in Table 21.1.
- Type
- Chapter
- Information
- Manual of Stem Cell and Bone Marrow Transplantation , pp. 130 - 153Publisher: Cambridge University PressPrint publication year: 2013