Oral infections in immunocompromised patients

The number of immunocompromised patients has increased during recent years, mainly because of more aggressive anti-cancer treatment and increased survival periods for end-stage cancer patients. Congenital and acquired immunodeficiencies are also more frequently recognized in dental practice due to increased diagnostic knowledge and increased numbers of HIV-infected persons. Oral complications and infections are related to the type and severeness of the immunodeficiency. Low amounts of immunoglobulins are known to play a rôle in many bacterial infections, e.g., upper respiratory tract infections, but have not yet been associated with specific oral conditions. T-cell defects tend to increase susceptibility towards oral infections with fungi and virus, and are also associated with periodontal disease in HIV-infected patients. Defects in the phagocytic system increase the risk of periodontal disease in certain patient groups. Severe granulocytopenia as observed, e.g., in leukemic patients increases the risk of septicemia with oral micro-organisms.