Published: May 2003
Intensive oral hygiene measures should be continued to ensure adequate plaque control and reduce the risk of rampant dental breakdown and oral infections. Daily fluoride (rinse or gel) may be necessary until salivary function recovers. Most patients conditioned with total body irradiation who do not develop chronic GVHD will recover normal salivary function 3-12 months post‑therapy.
Invasive dental procedures should only be planned following consultation with the patient's oncologist and/or the bone marrow transplant center's dentist. Elective procedures should be delayed approximately one year. Patients with chronic GVHD may experience long-term oral and systemic complications and present with difficult dental management problems. Children may experience altered craniofacial growth and tooth development. Post-bone marrow transplant patients and patients on long-term immunosuppressive drugs are at risk for second malignancies.