How Can Neutropenia Impact My Oral Health?

White blood cells help your body fight infections.² You have many different types of white blood cells, but the most numerous kind in your body is called a neutrophil.²

Neutropenia is a condition that occurs when your neutrophil count is low.² People with cancer may have neutropenia. Chemotherapy, radiation, surgery, stem cell or bone marrow transplants, steroids, or cancer itself can lower the number of white blood cells in your body. Without enough white blood cells, especially neutrophils, your immune system is compromised and your risk of getting an infection rises.² The risk is related to how severe the neutropenia is.⁴

The mucous membranes lining the mouth and the gums are susceptible to infection. When the mucous membranes are inflamed, this condition is called stomatitis.² People with stomatitis can develop sores in their mouths.³ If you have neutropenia, here’s what you can do to avoid an infection in your mouth as well as other parts of your body:

• Wash your hands often with soap and warm water. Using hand sanitizer can also help reduce bacteria and viruses.⁵ Do so before eating and before touching your face, eyes, nose, or mouth.^2,3

• Keep your mouth clean by brushing your teeth gently twice a day, paying special attention to the gum line. Ask your doctor if it’s okay to floss.²

• Rinse your toothbrush with water after each use. Store it in a dry place.³ Consider having more than one brush and rotating them so that each one dries out between uses. This lowers the amount of bacteria and fungi that may survive on a wet brush.⁶

• Skip mouthwashes that contain alcohol, which can irritate sensitive oral tissues. Instead, ask your doctor or dentist about a mild mouthwash or one with antibiotics to help prevent oral infections.³

Be sure to let your dentist know if you have neutropenia. Your dentist may want to prescribe antibiotics before performing a dental procedure to reduce your risk of infection.¹

¹ “Guideline on antibiotic prophylaxis for dental patients at risk for infection.” National Guideline Clearinghouse. www.guideline.gov/summary/summary.aspx?doc_id=14219 Accessed 2009.

² “Infections in People with Cancer.” American Cancer Society. www.cancer.org/docroot/ETO/content/ETO_1_2X_Infections_in_People_with_Cancer.asp Accessed 2009.

³ “Managing Side Effects.” American Cancer Society. www.cancer.org/docroot/ETO/content/ETO_1_6X_Managing_Side_Effects.asp?sitearea=ETO Accessed 2009.

⁴ “Neutropenia.” Current Medical Diagnosis and Treatment. Lange Medical Books/McGraw-Hill, ed. 44, 480.