Dental Management of Pediatric Patients Receiving Immunosuppressive Therapy and/or Radiation Therapy

Purpose

The American Academy of Pediatric Dentistry (AAPD) recognizes that the pediatric dental professional plays an important role in the diagnosis, prevention, stabilization, and treatment of oral and dental problems that can compromise the child’s quality of life before, during, and after immunosuppressive therapy which lowers the body’s normal immune response. This can be deliberate as in lowering the immune response to prevent the rejection of an organ or hematopoietic cell transplant* (HCT), or it can be incidental as in a side effect of chemotherapy, radiation therapy, or HCT conditioning. Dental intervention with certain modifications must be done promptly and efficiently, with attention to the patient’s medical history, treatment protocol, and health status.

Immunosuppressive therapy may cause many acute and long-term side effects in the oral cavity. Furthermore, any existing or potential sources of oral/dental infections and/or soft tissue trauma can compromise the medical treatment, leading to morbidity, mortality, and higher hospitalization costs. It is imperative that the pediatric dentist be familiar with the patient’s medical history as well as oral manifestations of the underlying condition.

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* The term HCT is also preferred to as hematopoietic stem cell transplantation (HSCT).