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Oral and dental management for people with lymphoma

From Volume 46, Issue 2, February 2019 | Pages 133-150

Authors

Hassan Abed

BDS, MSc, Dip RCS(I), MFDS RCPS(Glasg), MDTFEd, CAGS, PhD (KCL), Dip PDC RCS(I), MFD RCS(Ireland), PhD

Assistant Professor and Consultant of Conscious Sedation and Special Care Dentistry, Department of Basic and Clinical Oral Science, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia

Articles by Hassan Abed

Email Hassan Abed

Najla Nizarali

Specialist in Sedation and Special Care Dentistry, Department of Sedation and Special Care Dentistry, Floor 26 Tower Wing, Guy's Hospital, London Bridge, London SE1 9RT, UK

Articles by Najla Nizarali

Mary Burke

Senior Dental Officer in Sedation and Special Care Dentistry, Guy's and St Thomas' NHS Trust

Articles by Mary Burke

Abstract

Abstract: A lymphoma is a solid neoplasm that arises in lymphoid tissues and spreads to distant lymphoid glands and organs. Functional lymphocytes circulate the body in the lymphatic system as a part of the immune system. In lymphoma, proliferated abnormal lymphocytes collect in the lymphatic glands and organs with variant signs and symptoms based on the affected site. There are two main types of lymphoma: Hodgkin's lymphoma (HL) and non-Hodgkin's lymphoma (NHL), with different subtypes. The major aetiology is still unknown. Varying treatment modalities are available including monoclonal antibodies, chemotherapy, radiotherapy, corticosteroids and haematopoietic stem cell transplant (HSCT). These have acute and longer-term side-effects that affect clinical decision-making for dental treatment. Therefore, people with lymphoma benefit from a pre-treatment dental assessment and should have regular follow-up in primary care.

CPD/Clinical Relevance: This paper aims to provide dental care providers in the primary care setting, community dental service or hospital dental setting with knowledge to manage patients diagnosed with lymphoma.

Article

This paper offers a literature review that describes the recommended oral and dental management for people with lymphoma. From 1980 to 2017, the electronic databases, PubMed, Scopus and Google Scholar, were searched using the following keywords: lymphoma, treatment of lymphoma, monoclonal antibodies, medication-related osteonecrosis of the jaw, thrombocytopenia in relation to chemotherapy, neutropenia in relation to chemotherapy, antibiotic prophylactics, lymphoma and chemotherapy, radiotherapy and lymphoma. The search included both in vivo and in vitro studies published in the English language. The main inclusion criteria were any studies described ‘lymphoma’, ‘types of lymphoma’, ‘treatment of lymphoma’, ‘aetiology and physiology of lymphoma’, and ‘dental management of patients with lymphoma’.

Lymphoma is a solid neoplasm that arises in lymphoid tissues and spreads to distant lymphoid glands and organs.1 It occurs when abnormal lymphocytes increase in number without proper control. They divide in an abnormal pathway or do not die when they should. In 2015, the Office for National Statistics (ONS) reported that non-Hodgkin's lymphoma affected 11,690 patients, while Hodgkin's lymphoma affected 1,782 patients.2 However, in 2016, these incidences were increased to nearly 17,000 and 2,000 cases diagnosed with non-Hodgkin's lymphoma and Hodgkin's lymphoma, respectively.3 It affects any age, including children. Currently, it is mostly treatable, and people live for many years after being diagnosed.

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