A common treatment modality in oncology care is bone marrow transplant (BMT). In this treatment, a patient with cancer has their bone marrow replaced with healthy cells from a donor, often called a graft, so that it no longer contains cancer cells and has the ability to fight cancer.

 

Preparation for BMT is quite complex and is usually reserved for those who have already undergone chemotherapy. 

 

The following types of cancer are most amenable to BMT:

• Leukemia

• Lymphoma

 

Patients about to undergo BMT receive medication to suppress their immune system. Because of this, any infection, including oral infection, that has been festering as chronic, may become acute. A full oral examination and treatment to address potential sources of infection prior to BMT is critical.  Patients may be placed on life-long medication regimens after bone marrow transplant.

 

In the tissue graft are cells with immune system properties. These may react with cells of the host and result in tissue changes. This is called graft-versus host disease or GVHD. GVHD is chronic, and may affect oral tissues, such as mucosa, muscle and saliva.

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Following bone marrow transplant, routine preventive oral care can be resumed to maximize oral health. While less common, secondary cancers may occur which means a comprehensive oral exam of the mouth should be performed at each visit.

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For more information about bone marrow transplant and oral health, see these resources:

 

• Dental Management of the Organ or Stem Cell Transplant Patient from the National Institute of Dental and Craniofacial Research.

• Dental Provider’s Oncology Guide- National Institutes of Health

• Oral Complications of Cancer Treatment: What the Dental Team Can Do- National Institutes of Health 

• Oral Complications of Cancer Treatment: What the Oncology Team Can Do - National Institute of Dental & Craniofacial Research

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You may wish to learn more about:

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• Importance of good oral health before, during, and after cancer care

• Dental care and home care before, during and after treatment

• Finding dental care

• Financing dental care

• Oral exam for non-dental providers

• Radiation Therapy

• Chemotherapy

• Nutrition before, during, and after cancer care

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