Late complication | Prevention | Screening | Management |
Oral squamous cell carcinoma | Smoking cessation Moderate alcohol consumption | Annual clinical examination Biopsy of atypical/suspicious lesions | Referral to multidisciplinary head and neck oncology center |
Rampant dental caries | Minimize intake of refined carbohydrates (especially sugar-containing soft drinks) Brush at least twice daily, after eating when possible Floss daily Fluoride 1.1% gel paint on or in custom trays, daily Remineralizing agent, apply with fluoride Professional fluoride varnish application | Increased risk in patients with significant salivary gland cGVHD Increased risk in patients with orofacial sclerotic cGVHD Increased risk in patients were severe mucosal disease and avoidance of oral hygiene Examine teeth for evidence of cervical demineralization/decay Twice annual dental visits
| Treat dental caries as soon as diagnosed Careful follow-up for new or recurrent caries Reinforce oral hygiene and dietary habits Reinforce daily preventive measures |
Fibrosis | No known preventive measures | Ask patient if aware of tightness/limited opening Extensive sclerotic skin disease, especially with neck involved Examine for intraoral buccal fibrotic bands by palpation | Physical therapy Intralesional steroid therapy Surgery Systemic therapy for systemic involvement |
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