Review Article

Supportive Care in Cancer

, Volume 10, Issue 6, pp 466-473

Periodontal infection in cancer patients treated with high-dose chemotherapy

  • Judith E. Raber-DurlacherAffiliated withDepartment of Clinical Oncology, University Medical Center, P.O. Box 9600, 2300 RC Leiden
  • , Joel B. EpsteinAffiliated withBritish Columbia Cancer Agency, Vancouver Hospital and Health Sciences Centre, Vancouver, B.C.
  • , John RaberAffiliated withPeriodontal Clinic The Hague, The Hague
  • , Jaap T. van DisselAffiliated withDepartment of Infectious Diseases, Leiden University Medical Center
  • , Arie van WinkelhoffAffiliated withDepartment of Oral Biology, Academic Center for Dentistry, Amsterdam
  • , Harry F. GuiotAffiliated withDepartment of Infectious Diseases, Leiden University Medical Center
  • , Ubele van der VeldenAffiliated withDepartment of Periodontology, Academic Center for Dentistry, Amsterdam

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Abstract

The infected and inflamed periodontium can act as a focus for systemic infection in neutropenic cancer patients. The incidence of these oral infections is unknown, but probably underestimated. Periodontal infections can easily be overlooked, primarily because symptoms of gingival inflammation may be minimal and the infection may be located in deeper parts of the periodontium. Assessment of a patient's periodontal condition before the onset of profound neutropenia is critical to the diagnosis and the management of these potentially life-threatening infections. This review article is aimed at informing supportive care providers of recent insights into the pathogenesis of periodontal diseases and the role of subgingival microorganisms, with the emphasis on these infections in cancer patients treated with high-dose chemotherapy. Furthermore, a multidisciplinary approach to the management of periodontal infections and the need for future research is discussed.

Periodontal infection Subgingival microflora Febrile neutropenia Oral care