Considerations in the Pediatric Population with Cancer

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This article is divided into three time periods according to the different phases of cancer treatment: pre, inter, and postcancer therapy. The purpose of dental protocols prior to cancer therapy and the incidence and management of acute and long term oral complications from cancer therapy in the pediatric population are discussed.

Section snippets

Oral and dental management before initiation of cancer therapy

The diagnosis of cancer is overwhelming for families of affected children and many parents naturally focus on the medical aspects of treatment, overlooking the significance of oral health. Hematologic malignancies and most cancer treatment protocols are associated with immunosuppression, and the oral cavity, which is naturally colonized by and serves as a reservoir for a large number and variety of microorganisms, is a potential portal of entry for opportunistic infections [9], [10], [11], [12]

Dental treatment

In light of the risk of bacteremia and bleeding because of the patient's immunocompromised status during antineoplastic therapy, elective or nonemergency dental treatment should be deferred until after the completion of cancer therapy or recovery of the immune system.

If an acute odontogenic infection occurs in the midst of cancer therapy, discussion with the patient's physician is advisable before dental treatment is performed. Depending on the extent of the patient's bone marrow depression,

Summary

The importance of the oral cavity in systemic diseases is undisputed. Children and adolescents diagnosed with cancer may present with evidence of their primary disease in the oral cavity (eg, gingival infiltration by leukemia), which the dental professional may be the first to see. The acute and long-term oral sequelae caused by the therapies used to treat the underlying disease can be devastating in a growing body and significantly decrease the patient's quality of life. Increased

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