The importance of treating periodontal disease in oncology patients

Abstract:

Periodontitis is a chronic inflammatory disease of infectious etiology that affects the supporting tissue of the teeth. It is caused by specific periodontal pathogens from dentobacterial plaque (mostly gram-negative anaerobes). During the course of the disease, destruction of tooth supporting tissues creates deep periodontal pockets. Their ulcerative epithelium represents the site of entry for bacteria and their toxins into systemic circulation. In normal circumstances, the host’s immune system successfully fights against periodontal pathogens and neutralizes their dissemination. However, in cancer patients, whose immune system is suppressed by chemotherapy, neutropenia develops. This is a major challenge in treating these patients who are under a high risk of developing various bacterial infections. Infected periodontium in these patients may act as a focal point for a variety of systemic infections – especially as it is known that a mature dental plaque contains up to 1–2 × 1011 microorganisms per gram of plaque. Total surface area of the ulcerated periodontal pocket epithelium in severe forms of periodontitis may be up to 35 cm2. Therefore, in these patients timely diagnosis of periodontal disease and the implementation of appropriate therapeutic procedures are of utmost importance as it will significantly reduce the bacterial burden aiming to improve patient’s general health and minimize the risk of developing complications during chemotherapy treatment. 

Key words:
Chemotherapy; Gingivitis; Immune Response; Periodontitis