Patients Receiving Bone Marrow Transplant

During the initial phases of the transplant, the patient is at risk for developing mucositis (red and inflamed oral tissues), ulcerations, hemorrhage (bleeding), infections and xerostomia (dry mouth). The acute oral complications will start to resolve a couple months after transplant and when the hematologic status begins to improve.

What is Graft-Versus-Host Disease (GVHD)?

Patient’s receiving allogeneic bone marrow transplants or transplants from someone other than themselves are at risk for developing acute and chronic GVHD.

Some GVHD oral side effects include:

  • Mucositis > inflammation of the tissue inside your mouth
  • Xerostomia with secondary cavities
  • Mucosal atrophy > gum thin and recede
  • Ulcerations
  • Oral infections > for example: candidiasis
  • Immune-related complications > for example: lichenoid reactions, limited mouth opening and tongue mobility
Figure 1: Ulcerations
Figure 2: Oral infections
Oral infections
Figure 3: Candidiasis
Figure 4: Immune-related complications
Immune-related complications

Why is it important to see dentistry before having a bone marrow transplant (BMT)?

The goal of pre-BMT dental evaluation and treatment is to eliminate sources of infection and irritation. If dental treatment is needed, it will be scheduled in consultation with the oncologist.

Many patients will remain immunosuppressed for up to one year post-BMT and all elective dental work will be held until the patient has been deemed fit for treatment.