Immunosuppression And Chemotherapy

Inimunosuppressed patients have impaired host defenses as a result ol an underlying immunodeficiency or drug administration (primarily related to organ transplantation or cancer chemotherapy).Because chemotherapy is often cytotoxic to bone marrow, destruction of platelets and red and white blood cells results in thrombocytopenia, anemia, and leukopenia. Inimunosuppressed individuals are al greatly increased risk for Initec tion, and even minor periodontal infections can become life threatening if immune suppression is severe. Intraoral^, bacterial, viral, and fungal infections may manifest. Patients receiving bone marrow transplantation require special attention because these patients receive very high-dose chemotherapy and are particular!) susceptible to dissemination of oral infections.

Treatment in these patients should be directed toward the prevention of oral complications that could be life threatening. The greatest potential for infection occurs during periods of extreme immunosuppression; therefore treatment should be conservative and palliative. It is always preferable to evaluate the patient before initiation ol chemotherapy.w-ss Teeth having a poor prognosis should he extracted, with thorough debridement of remaining teeth to minimize the microbial load. The clinician must teach and emphasize the importance of good oral hygiene. Antimicrobial rinses such as chlorhexidine are recommended, especially for patients with chemotlierap\ -induced mucositis, to prevent secondars infection.

Chemotherapy is usually performed in cycles, with each cycle lasting several days toi lowed by intervening periods of myelosuppression and recovery. It periodontal therapy is needed during chemotherapy, it is best clone the day before chemotherapy is given, when white cell counts are relatively high. Coordination with the oncologist is critical. Dental treatment should be done when white cell counts are above 2000/mm\ with an absolute granulocyte count of 1000 to 15(X)/mm\ts

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  • layton
    Can a chemotherapy patient have perio treatment?
    4 years ago

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