Dental Management of Pediatric Patients Receiving Chemotherapy, Hematopoietic Cell Transplantation, 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 cancer treatment. Dental intervention with certain modifications must be done promptly and efficiently, with attention to the patient's medical history, treatment protocol, and health status. Chemotherapy and/or radiotherapy for the treatment of cancer or in preparation for hematopoietic cell transplantation (HCT)* may cause many acute and long-term side effects in the oral cavity. Furthermore, because of the immunosuppres-sion that patients experience, 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 pedi-atric dentist be familiar with the medical history as well as oral manifestations of the patient's underlying condition and the treatment differences for patients undergoing chemotherapy and/or radiotherapy and those who will receive HCT. Methods This guideline is and update of the previous document adopted in 1986 and last revised in 2008. The revision included a new systematic literature search of the PubMed ® electronic data-through age 18. Sixty one thousand four hundred thirty two articles matched these criteria. One hundred thirty three papers were chosen for review from this list and from the references within selected articles. When data did not appear sufficient or were inconclusive, recommendations were based upon expert and/or consensus opinion by experienced researchers and clinicians.