RT Journal Article
SR Electronic
T1 A Review of Oral Chronic Graft-Versus-Host Disease: Considerations for dental hygiene practice
JF American Dental Hygienists' Association
JO J Dent Hyg
FD American Dental Hygienists Association
SP 6
OP 17
VO 96
IS 2
A1 Lisa Bennett Johnson
A1 Uhlee Oh
A1 Marilynn Rothen
A1 Herve Y. Sroussi
A1 David R Dean
A1 C. Michele Lloid
A1 Katelyn Cintron
A1 Stephanie J. Lee
A1 Corey S. Cutler
A1 Nathaniel S. Treister
YR 2022
UL http://jdh.adha.org/content/96/2/6.abstract
AB Purpose: Allogeneic hematopoietic cell transplantation (alloHCT), also known as stem cell or bone marrow transplantation, is a cellular therapy performed to treat a variety of malignant and non-malignant hematologic diseases. Chronic graft-versus-host disease (cGVHD) is a common immune-mediated complication of alloHCT that can affect various organs of the body, with approximately 70% of affected patients presenting with oral features. Oral manifestations of cGVHD include lichenoid lesions (diagnostic feature), erythema, pseudomembranous ulcerations, superficial mucoceles, salivary gland hypofunction, xerostomia, orofacial sclerosis, trismus, and increased sensitivity to spicy, acidic, hard, and crunchy foods. Patients with oral cGVHD are also at increased risk for developing secondary conditions, such as oral candidiasis, dental caries, and oral squamous cell carcinoma. Given these complex oral health challenges, the dental hygienist can play a key role in optimizing patients’ oral health care from pre-stem cell transplantation through survivorship. Optimal care includes a comprehensive health history assessment, thorough extraoral and intraoral examinations, detailed hard and soft tissue evaluations, oral hygiene, and dietary assessment, along with the delivery of patient-centered, oral health instruction and preventive therapies. Appropriate monitoring and management of oral cGVHD require a collaborative care approach between dental, oncology, and oral medicine providers. As part of a multidisciplinary care team, dental hygienists play an important role in the management of patients with oral cGVHD. The purpose of this review is to provide an overview of alloHCT and its oral health considerations, with a focus on oral cGVHD etiology, signs and symptoms, and management considerations for the dental team.