Oral health problems can relate to:
- Problems that can affect anyone such as caries (tooth decay), periodontal (gum) disease, abscesses or tooth loss.
- Problems due to blood cancer.
- Problems linked to the treatment of the blood cancer including chemotherapy, radiotherapy or transplant.
1. Problems that can affect anyone
|Caries (tooth decay)||Hard tissues of the teeth are destroyed.||Pain – initially comes and goes before becoming constant. Can lead to abscesses. Poor appearance.||Removal of decay and placement of fillings or extraction of the tooth. Improving oral hygiene.|
|Periodontal (gum) disease||The gums peel away from the tooth and then shrink back with loss of the supporting bone.||Gum recession (‘long in the tooth’). Sensitive teeth. Mobile teeth that will eventually fall out. Bad taste and breath. Can lead to abscesses. Poor appearance||Cleaning of the involved areas or extraction of the tooth. Improving oral hygiene.|
|Abscess||Focus of infection leading to a collection of pus.||Severe, constant pain. Bad taste. Feel unwell.||Treat the cause of the abscess – may involve extraction of a tooth.|
|Tooth loss||Gaps after teeth have been extracted, usually due to caries or gum disease.||Difficulty chewing. Food gets stuck in gaps. Poor appearance.||Replacing the missing teeth with dentures, bridges or implants.|
2. Problems due to blood cancer
Oral problems due to blood cancer relate to:
- Anaemia with soreness at the corners of the mouth and involving the soft tissue lining of the mouth. The soreness can be made worse by infections such as candidiasis – the ‘thrush germ’.
- Neutropenia- a low number of neutrophil white blood cells, can lead to mouth ulcers.
- Any oral mucosal soreness can be made worse by infections such as candidiasis- the ‘thrush germ’.
- Focal deposits of blood cancer (e.g. some types of leukaemia) in the mouth (e.g. painful swelling of the gums with bleeding and possibly looseness of the associated teeth).
3. Problems linked to the treatment of blood cancer
A wide range of different chemotherapy, radiotherapy and transplant treatments are used to treat blood cancers. Many of these treatments impact on the mouth and can cause:
- Soreness of the mouth due to:
- Damage to the lining of the mouth
- Changes to the amount and quality of saliva
- Changes to the sense of taste
In patients who have poor oral health before they start the blood cancer treatments, they may also have or develop some of the problems outlined in section 1 above.