Patients who have received transplants are at risk of graft-versus-host disease.

Graft-versus-host disease (GVHD) is a reaction of donated bone marrow or stem cells against the patient's tissue. Symptoms of oral GVHD include the following:

• Sores that appear in the mouth 2 to 3 weeks after the transplant.
• Dry mouth.
• Pain from spices, alcohol, or flavoring (such as mint in toothpaste).

Biopsies taken from the lining of the mouth and salivary glands may be needed to diagnose oral GVHD. Treatment of oral GVHD may include the following:

• Topical rinses, gels, creams, or powders.
• Antifungal drugs taken by mouth or injection.
• Psoralen (a drug used with ultraviolet light to treat skin disease).
• Drugs that promote the production of saliva.
• Fluoride treatments.
• Treatments to replace minerals lost from teeth by acids in the mouth.

Dentures, braces, and oral appliances require special care during high-dose chemotherapy and/or stem cell transplant.

The following are guidelines for the care and use of dentures, braces, and other oral appliances during high-dose chemotherapy and/or stem cell transplant

• Remove brackets, wires, and retainers before high-dose chemotherapy begins.



• Wear dentures only when eating during the first 3 to 4 weeks after the transplant.



• Brush dentures twice a day and rinse them well.



• Soak dentures in an antibacterial solution when they are not being worn.



• Clean denture soaking cups and change denture soaking solution every day.



• Remove appliances or dentures when cleaning the mouth.



• If mouth sores are present, avoid wearing removable appliances until the mouth is healed.

Dental treatments may be resumed when the transplant patient's immune system returns to normal.

Routine dental treatments, including scaling and polishing, should be delayed until the transplant patient's immune system returns to normal. Caution is advised for at least a year after the transplant.

Glossary Terms

A drug that treats infections caused by fungi.

The removal of cells or tissues for examination by a pathologist. The pathologist may study the tissue under a microscope or perform other tests on the cells or tissue. There are many different types of biopsy procedures. The most common types include: (1) incisional biopsy, in which only a sample of tissue is removed; (2) excisional biopsy, in which an entire lump or suspicious area is removed; and (3) needle biopsy, in which a sample of tissue or fluid is removed with a needle. When a wide needle is used, the procedure is called a core biopsy. When a thin needle is used, the procedure is called a fine-needle aspiration biopsy.

The soft, sponge-like tissue in the center of most bones. It produces white blood cells, red blood cells, and platelets.

The process of identifying a disease by the signs and symptoms.

Any substance, other than food, that is used to prevent, diagnose, treat or relieve symptoms of a disease or abnormal condition. Also refers to a substance that alters mood or body function, or that can be habit-forming or addictive, especially a narcotic.

A substance that helps prevent tooth decay. Fluoride may be naturally present in or may be added to drinking water. It may also be applied to the teeth in a gel, toothpaste, or a rinse.

GVHD. A reaction of donated stem cells against the patient’s tissue. Also called GVHD.

An intensive drug treatment to kill cancer cells, but that also destroys the bone marrow and can cause other severe side effects. High-dose chemotherapy is usually followed by bone marrow or stem cell transplantation to rebuild the bone marrow.

The complex group of organs and cells that defends the body against infections and other diseases.

Use of a syringe and needle to push fluids or drugs into the body; often called a "shot."

A nutrient required to maintain health.

By or having to do with the mouth.

A substance from plants that is sensitive to light (or can be activated by light). Psoralens are used together with UV light to treat psoriasis, vitiligo, and skin nodules of cutaneous T-cell lymphoma. They are also being studied in the treatment of graft-versus-host disease. Psoralen is a type of furocoumarin. An example of a psoralen is methoxsalen.

The watery fluid in the mouth made by the salivary glands. Saliva moistens food to help digestion and it helps protect the mouth against infections.

A gland in the mouth that produces saliva.

A cell from which other types of cells develop. For example, blood cells develop from blood-forming stem cells.

A method of replacing immature blood-forming cells that were destroyed by cancer treatment. The stem cells are given to the person after treatment to help the bone marrow recover and continue producing healthy blood cells.

An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.

A group or layer of cells that work together to perform a specific function.

On the surface of the body.

The replacement of tissue with tissue from the person’s own body or from another person.

Invisible rays that are part of the energy that comes from the sun. UV radiation also comes from sun lamps and tanning beds. UV radiation can damage the skin and cause melanoma and other types of skin cancer. UV radiation that reaches the Earth's surface is made up of two types of rays, called UVA and UVB rays. UVB rays are more likely than UVA rays to cause sunburn, but UVA rays pass deeper into the skin. Scientists have long thought that UVB radiation can cause melanoma and other types of skin cancer. They now think that UVA radiation also may add to skin damage that can lead to skin cancer and cause premature aging. For this reason, skin specialists recommend that people use sunscreens that reflect, absorb, or scatter both kinds of UV radiation. Also called UV radiation.