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Leukemia and Intraoral Symptoms
Lots of systemic diseases are risk factors for tooth and its surrounding tissue. These diseases harm the related cells, tissues and organs and they also have oral symptoms. Even, these symptoms may help early detection of a systemic disease. Effect of every disease is different in every patient. This may be explained with differences in immune system.
Etiology of the leukemia is not all clear. The leukemia is a malignant disease characterized by uncontrolled proliferation of abnormal white blood cells called ‘leukocytes’. These white blood cells may be immature (acute leukemia) or mature (chronic leukemia). Increased numbers of the leukocytes in the bone marrow causes blood coagulation disorders and decreased immune system cells. As a result, infection risk and bleeding tendency is increased in the leukemia. Anemia and lymph node enlargement may be seen. Intraoral symptoms are also frequent. Gums may bleed by a small contact or spontaneously due to blood cells disorders. Petechiae, small hemorrhagic focuses intraoral mucosa, ulcers and widespread bruises in the periodontal tissues may be seen. Localized or generalized gum growth is also one of the intraoral symptoms of leukemia. Today, early detection of the leukemia is possible with such specific findings.
Leukemia patients should pay the highest attention to the oral hygiene. Dentists have an important role to provide this. Periodontal tissues such as teeth, alveolar bone, periodontal ligament and gum are suitable for bacterial growth. Immune system is weak in leukemia and even the smallest infections may become sever. These patients avoid to brush teeth because of the high risk of the bleeding. Therefore, intraoral problems are inevitable. Dentist should show proper and effective brushing technique to the patients. Soft toothbrush should be used. Mouthwash should be recommended to decrease the number of microorganisms in the mouth. Dental procedures should be performed under antibiotic prophylaxis against the risk of infection. A hematologist and oncologist should be consulted before operations that may cause severe bleeding.