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The Leukemia/Bone Marrow Transplant Program of BC

Your Responsibilities
Preventing Infection

Mouth Care

Prior to Treatment

It is very important that prior to treatment, you see your dentist to identify and take care of any outstanding dental issues you may be having. Good oral hygiene will be important to you before, during and after your transplant.

The dental team is committed to supporting the Leukemia/BMT Program. You may be referred to the VGH Dental Clinic or the BCCA Dental Clinic if you require emergency dental treatment. Following discharge, our specially trained dentists are available to consult with your community dentist about general dental care.

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Taking Care of Your Mouth, Teeth & Gums

  • Inspect your mouth, teeth, and gums before and after your mouth care routines.
  • Floss your teeth daily and brush your teeth after every meal and at bedtime.
  • Brush with a soft toothbrush in the morning, after meals and at bedtime. The toothbrush can be further softened under hot water if necessary for tissue comfort. Brush the gums, tongue and palate as well as the teeth. Toothbrushes should be changed every two weeks. Regular toothpaste may cause discomfort to fragile tissues. Use a milder product. The dental staff can make recommendations.
  • Clean your toothbrush by rinsing it well after brushing.
  • Rinse with chlorhexidine - a medicinal mouthwash - in the morning, after meals and at bedtime.
  • Remove dentures, except for mealtimes. Dentures must be kept meticulously clean and should be soaked in denture solution when not being worn. They must be thoroughly rinsed before insertion.
  • Avoid sweets, juice and soft drinks, except at meals.  For comfort when the mouth is dry, use plain, unflavoured water.
  • Avoid Vaseline or other petroleum products for dry lips. Lanolin is the recommended alternative. Having a lip balm is very useful especially if you are having radiation because your lips can actually burn. Burned lips sometimes become cracked and can bleed, which can lead to an increased risk for infection.
  • Avoid commercial mouthwashes since most of them contain alcohol that can dry or irritate your mouth. 
  • Avoid brushing/flossing if you are bleeding, have sores or it becomes painful and difficult. A special mouth rinse will be prescribed for you. Use this to rinse your mouth thoroughly at least four times a day.

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Post-Transplant Mouth Care

Once your blood cell counts begin to recover, we encourage you to continue with diligent and thorough mouth care and personal hygiene routines. You should:

  • Change your toothbrush once a month for the first 6 months after you are discharged.
  • Have a dental exam every six months.
  • Contact your BMT doctor before you have any dental work done, as you may need antibiotics. Your BMT doctor and dentist will advise you.

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Mucositis & Management

One of the side effects of chemotherapy may be mucositis. This is a condition in which cells lining the inside of your mouth and throat become irritated and painful. It can significantly affect your ability to swallow and/or talk. Mucositis reverses itself once you recover from the chemotherapy.

As a result of mucositis, you may develop sores. If your mouth is not kept clean, an infection can occur that can potentially spread to other parts of your body. You will be given medications to help prevent infections if the sores develop, but the most important part will be keeping your mouth clean.

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