Rethinking the Oral Signs of Leukemia
My guest, Dr. Erin Watson is a general dentist practicing at Princess Margaret Cancer Center in Toronto. She presented the findings of a study that she and other colleagues conducted about the oral manifestations of leukemia and recently published in the Journal of the American Dental Association. The article is titled: Prevalence of oral lesions in and dental needs of patients with newly diagnosed acute leukemia.
Dr. Watson and her colleagues posed the hypothesis of whether or not the traditional thinking about oral manifestations of leukemia in patients still holds true or if oral health care providers should rethink how they suspect the presence of the disease in a given patient.
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Chiraz Guessaier, CDA Oasis Manager
Dentists are generally taught that in a significant number of patients with newly diagnosed acute leukemia (NDAL), the diagnosis may be suspected based on oral signs. In this study, the authors determined the frequency of oral signs of leukemia and tabulated the clinical dental needs and hematologic aspects of these patients.
Four calibrated dentists performed clinical examinations in 263 consecutive patients with NDAL. A standardized data form was used to direct and record presence or absence of oral signs of leukemia, clinically apparent dental disease, and circulating blood counts.
Although 30.8% of patients examined had some oral sign of leukemia, most adults with NDAL do not have GE at the initial examination. Even patients receiving regular oral health care may have unmet dental needs at the initial assessment that could safely be addressed before
Practical Implications. Dentists should not necessarily expect to be able to detect overt oral signs of leukemia, such as GE, in patients with NDAL on oral examination. Once patients receive the diagnosis, dentists may be able to safely eliminate dental disease in most patients in an appropriate setting. Dentists are encouraged to undertake a thorough review of systems.
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