Clinical Guidelines for the Prevention and Management of Oral and Dental Complications in Pediatric Oncology Patients: A Narrative Review



Abdolkarimi B ; Amanati A ; Derikvand N ; Panahi N ; Mirzaei S
Source: Iranian Journal of Blood and Cancer Published:2025

Abstract

Background: Oral complications are among the most frequent and debilitating adverse effects of cancer therapy in pediatric patients. Chemotherapy, radiotherapy, and hematopoietic stem cell transplantation can result in acute manifestations such as mucositis, infections, bleeding, and pain, as well as long-term sequelae including dental developmental abnormalities, craniofacial growth disturbances, and xerostomia. Comprehensive oral care is therefore a critical component of supportive oncology management. Objectives: This narrative review aims to summarize current evidence regarding oral and dental care strategies for pediatric oncology patients, focusing on preventive assessment, hygiene maintenance, management of treatment-related complications, and long-term follow-up. Methods: Relevant literature was reviewed to consolidate clinical recommendations and evidence-based strategies for oral care in children undergoing oncology treatment. The review highlights practical approaches for pre-treatment dental evaluation, in-treatment oral hygiene and infection control, and post-treatment follow-up, with integration of levels of evidence where available. Results: Pre-treatment dental assessment and elimination of infectious foci significantly reduce oral and systemic complications. During active therapy, gentle oral hygiene practices, fluoride use, antiseptic rinses, and careful management of pain and infection are essential. Oral mucositis remains the most common dose-limiting complication, and preventive strategies such as cryotherapy, keratinocyte growth factors, and low-level laser therapy demonstrate strong supporting evidence. Post-treatment follow-up should include regular dental visits, ongoing preventive care, and monitoring for late sequelae such as dental developmental anomalies and xerostomia. Conclusions: Structured oral care, encompassing pre-treatment assessment, active therapy management, and long-term follow-up, is essential to minimize morbidity and improve quality of life in pediatric oncology patients. Evidence-based interventions, particularly for mucositis prevention and caries management, provide a foundation for standardized clinical practice and highlight areas for future research. © 2025, Iranian Pediatric Hematology and Oncology Society. All rights reserved.