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Oral Complications of Chemotherapy and Head/Neck Radiation

Management of Oral Complications of High-Dose Chemotherapy and/or Stem Cell Transplant

Patients who have received transplants are at risk of graft-versus-host disease.

Graft-versus-host disease (GVHD) is a reaction of donated bone marrow or stem cells against the patient's tissue. Graft-versus-host disease can cause inflammation and breakdown of the mucous membranes. Symptoms of oral GVHD include the following:

It's important to have these symptoms treated as they can lead to weight loss or malnutrition.

Biopsies taken from the lining of the mouth and salivary glands may be needed to diagnose oral GVHD. Treatment of oral GVHD may include the following:

Dentures, braces, and oral appliances require special care during high-dose chemotherapy and/or stem cell transplant.

The following are instructions for the care and use of dentures, braces, and other oral appliances during high-dose chemotherapy and/or stem cell transplant:

Care of the teeth and gums may continue under professional guidance.

Careful brushing and flossing may help prevent infection of oral tissues. The following are guidelines for general oral care during high-dose chemotherapy and stem cell transplant, but it's important that patients check with their medical professional for individual guidelines:

Dental treatments may be resumed when the transplant patient's immune system returns to normal.

Routine dental treatments, including scaling and polishing, should be delayed until the transplant patient's immune system returns to normal. The immune system can take 6 to 12 months to recover after high-dose chemotherapy and stem cell transplant. During this time, the risk of oral complications remains high. If dental treatments are needed, antibiotics and supportive care are given. Care must be taken to prevent accidentally breathing fluids into the lungs during dental treatments.