Leukemia and Oral Symptoms: Swollen Gums, Bleeding, and More
If you have leukemia, a dental issue like bleeding in the mouth may be one of the first symptoms you experience.
Leukemia is a type of cancer that affects blood cells. It begins when a cell's DNA in the bone marrow or other blood-forming tissues mutates, causing blood cells to develop and function abnormally. These abnormal blood cells are leukemia cells.
Leukemia is a systemic disease, meaning that it affects blood components throughout the entire body. Leukemia may cause a hematoma — pooling of the blood under the skin — and bleeding in various areas of the body, including the mouth.
It’s easy to overlook minor symptoms like swollen or bleeding gums, but they may be one of the earliest signs of some types of leukemia.
“We see our patients more frequently than the primary care physician, and often a dentist may be the first doctor that notices the symptoms of leukemia,” says Jessica Pharar, DMD, the founder of the Pharar Foundation, an organization in Las Vegas that provides specialized dental care for patients with cancer and other chronic conditions.
Leukemia cells may also infiltrate the gums, causing unusual gum lesions or inflammation, which your dentist may notice.
“We will usually reevaluate a concerning area [such as inflamed gums] in two weeks to allow your body to heal the area. If the concerning lesion does not heal within two weeks, we will then progress the care to another provider, such as an oncologist,” Dr. Pharar explains.
According to an article published in Hematology, Transfusion and Cell Therapy in 2022, oral symptoms were most commonly seen in the following types of leukemia:
Not everyone with leukemia experiences oral symptoms, according to Sudarsan Kollimuttathuillam, MD, a medical oncologist and hematologist at City of Hope in Huntington Beach, California. “However, it is fairly common during treatment of leukemia, especially chemotherapy,” he says. “[Leukemia] and its treatment can affect the mouth in various ways such as bleeding gums, overgrowth of the gums (gingival hyperplasia), ulcers, and inflammation of the mouth.”
Other oral symptoms seen in leukemia are:
When these signs and symptoms do exist, they are usually a result of:
Blood clotting problems Leukemia can affect the level of platelets in your body, which are the cells that help your blood clot. Disruption of your body’s natural clotting processes may cause easy bleeding or bruising of the gums, tongue, or lips.
Treatment effects Sometimes leukemia treatment causes side effects that affect the teeth, mouth, and jaw. For example, chemotherapy can cause dental issues such as mouth sores, tooth decay, pain, and dry mouth.
Infections People with leukemia are at higher risk for infections like oral herpes and candidiasis because of a weakened immune system. These infections can cause symptoms like sores, blisters, and white lesions on the mouth.
RELATED: What Are Common Symptoms of Leukemia?
Leukemia’s effect on the mouth may cause other problems that can significantly reduce your quality of life.
Try the following strategies to soothe and reduce your mouth symptoms.
Some oral symptoms will improve on their own, while others will need treatment. For instance, gum issues may improve or resolve as the cancer goes into remission. But “damage to the teeth and salivary glands due to leukemia treatment would require additional, separate dental treatment,” Pharar says.
If you have already received a diagnosis of leukemia, consider prioritizing your dental health as part of a holistic treatment approach. It is best to work with your healthcare team, including your dentist, to ensure optimal dental health during and after your treatment.
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