Oral manifestations of leukemia

Leukemia is a cancerous disease that affects circulating blood cells.

The origin of this disease is in the bone marrow.

Patients with leukemia have elevated white blood cell counts. While normal leukocyte values range from 4000 to 9000 per cubic mm, in leukemia, values can rise to over 25,000 per cubic mm.

Leukocytes are the cells of the white blood series. As they increase, the number of red blood cells in the body decreases. This leads to anemia.

Acute leukemia has an accelerated progression and the patient presents relatively quickly to the family doctor because of the marked symptoms.

The symptoms patients experience are as follows:

Asthenia – feeling tired without exerting considerable effort. Sometimes patients report getting tired much faster with simple daily activities.

Abdominal pain – this is especially present in leukemia affecting children.

Weight loss – patients can follow a normal diet and still lose weight. Other times, weight loss is due to lack of appetite.

Bacterial infections – leukemia patients have a weakened immune system. This means they possess a predisposition to fight off infections. These can overlap and the negative effects can accumulate, weakening the body’s resistance.

Hemorrhages – are due to a decrease in the number of red blood cells and increased fragility of the vascular walls. Bleeding can occur on the skin, but also in the oral mucosa and gums.

Adenopathy – the lymph nodes in the neck or groin area may become inflamed, but the pain in these nodes may be mild or absent.


Manifestations of acute leukemia in the oral cavity are numerous and include :

Increased gingival volume – called gingivitis, this condition is based on an increase in cell volume in the gingival epithelium and corium.

This pathology worsens in direct proportion to the amount of bacterial plaque present on the tooth surfaces.

Even with good oral hygiene, gingivitis may be present, but its intensity is mild or moderate.

Gingivorrhagia – known to patients as bleeding gums. This symptom is alarming for the patient who will tend to spare their gums during chewing or oral hygiene so as not to exacerbate the bleeding. Thus, considerable plaque and tartar deposits will be present on the teeth.

The oral mucosa will be pale due to generalized anemia.

In the case of surgery in the oral space, the risk of superinfection is increased.

Also, bacterial foci kept in balance by the oral cavity’s defence mechanisms may now exacerbate. Migration of cells involved in antibacterial defence is reduced.

Incorrectly performed prosthetic work or fillings can cause more rapid and more severe damage to the oral mucosa or gums.

Ulcerations frequently occur and can become superinfected.

The oral mucosa may also show darker colored patches due to a decrease in the number of cells in the red series.

The patient should mention the stage of the disease to the dentist in the history and, if necessary, present the results of blood tests. Hemoleucogram values dictate which interventions can and cannot be performed.

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