Prior to chemotherapy or bone marrow transplant, what dental clearance is recommended?

• A. Eliminate all infections and significant caries
• B. Close the clinic and cancel all dental care indefinitely
• C. Only treat emergencies during chemotherapy
• D. Postpone all dental care for one year

Answer: (A)

Before high-dose chemotherapy or bone marrow transplant, the dental goal is to remove sources of infection and major dental disease. This reduces the risk of odontogenic infections and bacteremia when the immune system is suppressed by treatment, and helps prevent oral complications like mucositis that can disrupt therapy. The clearance involves evaluating the mouth, treating active infections, restoring caries where feasible, addressing periodontal issues, and extracting teeth that are nonrestorable or pose a persistent infection risk. By achieving a mouth free of active infection and significant disease, chemotherapy and transplant can proceed more safely with fewer treatment-related oral complications. Leaving infections unaddressed or delaying all care indefinitely would raise the risk of complications during therapy, while only treating emergencies during treatment does not remove existing sources of infection beforehand.