Evaluation of the oral health status in Egyptians with acute leukemia by risk stratification and impact of an oral hygiene education program

Background
Acute leukemia (AL) is the most common type of cancer in children. Common oral morbidities include mouth ulcers, mucositis, herpes, candidiasis, bacterial infections, and bleeding. Although outcomes for Egyptian children with AL have improved, recurrent infections and bleeding remain major challenges during treatment.


Objective
This study aimed to evaluate the dental health status of children aged 4–12 years diagnosed with acute lymphoblastic leukemia (ALL) or acute myeloid leukemia (AML), attending the Ain Shams Pediatric Oncology Clinic, and to assess the effectiveness of an oral hygiene education program.


Patients and methods
A total of 114 children with AL (51 with standard-risk ALL, 31 with high-risk ALL, and 32 with AML) were enrolled between 2022 and 2024. Participants were randomly assigned to either an intervention group (n=66), which received quarterly oral hygiene education and follow-up over 12 months, or a nonintervention group (n=22) that completed the study without receiving the educational intervention. The oral hygiene index simplified (OHI-S) and the decayed, missing, and filled surfaces index were recorded at baseline and after 12 months.


Results
The baseline mean OHI-S score was 2.71±0.62. After 12 months, the intervention group showed a significant reduction in the mean OHI-S score to 1.42 (P<0.01). There was also a significant decrease in the frequency of severe annual oral infections and bleeding in the intervention group—particularly among high-risk ALL and AML patients—compared with the nonintervention group. This improvement was associated with fewer interruptions in chemotherapy treatment.


Conclusion
Implementing a structured oral hygiene education and care program significantly improved oral health outcomes in children with high-risk ALL and AML. This contributed to fewer chemotherapy interruptions and a potential survival benefit.