Leukemia is a type of blood cancer that starts in the bone marrow and results in high numbers of abnormal white blood cells. These abnormal cells can infiltrate various parts of the body, including the gums. When leukemia cells accumulate in the gums, it can cause the gums to take on an abnormal appearance.
Signs of Leukemia in the Gums
There are a few key signs that may indicate leukemia is affecting the gums:
- Swollen or inflamed gums
- Bleeding gums
- Gum pain or tenderness
- Abnormal gum color – pale pink, red, or purplish
- Sores or ulcers on the gums
- Enlarged gums
Let’s explore each of these symptoms more closely:
Swollen, Inflamed Gums
One of the most common signs of leukemia in the gums is swelling and inflammation. This occurs as abnormal white blood cells infiltrate the gum tissue, causing it to become irritated, puffy and tender. The gums may appear slightly swollen or dramatically enlarged.
Bleeding Gums
Gum bleeding is also common with leukemia. When gums are inflamed and irritated by cancer cells, they can become fragile and prone to bleeding. Bleeding may occur spontaneously or with minimal trauma such as tooth brushing.
Gum Pain/Tenderness
The accumulation of leukemia cells in the gums causes inflammation, which leads to gum tenderness and pain. Gum pain may range from mild to severe. Some people describe a throbbing, aching pain.
Abnormal Gum Color
The normal gum color is a light pinkish-hue. In leukemia, the color may become pale pink, vivid red, purplish or bluish-red. This is caused by the excess of abnormal blood cells in the gum tissue.
Gum Sores/Ulcers
Leukemia can sometimes cause painful mouth sores or ulcers to develop on the gums. Ulcers have an open, weeping appearance. The ulcers are a result of the abnormal white blood cells damaging and breaking down gum tissue.
Enlarged Gums
In some cases, leukemia gums are symmetrically enlarged. This means the swelling is uniform, affecting the entire gumline. Other times, the enlargement may be isolated to one area. When leukemia cells infiltrate the gums, it causes thickening and swelling of the soft gum tissues.
Underlying Causes
So what’s actually causing these gum changes in leukemia? There are a few key factors at play:
- High white blood cell count – Leukemia leads to overproduction of abnormal white blood cells by the bone marrow. Many of these immature white cells then enter the gum tissues, causing irritation.
- Reduced platelets – Platelets help with blood clotting and wound healing. In leukemia, low platelet levels can contribute to easy bleeding and poor healing.
- Reduced red blood cells – Anemia from low red blood cells reduces oxygen delivery, which can cause gums to appear pale or purple-ish.
- Weakened immune function – Leukemia suppresses the immune system, increasing susceptibility to opportunistic gum infections.
The combination of these factors creates an environment in the gums that allows leukemia cells to thrive and destroy gum tissue, resulting in many of the symptoms described above.
Differences by Leukemia Type
There are different classifications of leukemia based on the type of blood cell involved – myeloid cells or lymphoid cells. Lymphoid leukemia affects lymphocytes and myeloid leukemia involves myeloblasts. The gum symptoms may vary slightly between different subtypes:
Acute Myeloid Leukemia (AML)
- Severe, painful gum swelling
- Bleeding gums
- Gum ulcers
- Grayish-red gums
Chronic Myeloid Leukemia (CML)
- Mild gum inflammation
- Occasional bleeding
- Pale, enlarged gums
Acute Lymphoblastic Leukemia (ALL)
- Painful, bleeding enlarged gums
- Red or purplish gums
- Gum ulcers
Chronic Lymphocytic Leukemia (CLL)
- Mild gum swelling
- Pale or bluish gums
- Not as painful as other types
So while some overall gum symptoms are consistent across leukemia subtypes, the severity and exact presentation can vary depending on the cells involved.
How is Leukemia Diagnosed from Gum Symptoms?
If a dentist or dental hygienist notices suspicious looking gums during an oral exam, they may suspect an underlying blood disorder like leukemia could be responsible. But gum abnormalities alone are not enough for a leukemia diagnosis.
Instead, the dentist will refer the patient to a physician for further testing. The doctor will check for other signs and symptoms of leukemia. They will also order blood tests to look at the numbers and appearance of white blood cells, red blood cells and platelets. Finally, a bone marrow biopsy can confirm the diagnosis by detecting cancerous cells in the marrow.
So while the gum changes may provide the first clue, a full medical workup is needed to determine if leukemia is truly present.
Leukemia Gum Symptoms in Children
Leukemia is the most common type of childhood cancer, so it’s important to watch for symptoms in children. Gum abnormalities can sometimes be the first tip-off that a child may have leukemia.
Some key leukemia gum symptoms to look for in children include:
- Swollen, painful gums
- Reddish or purplish gums
- Bleeding gums
- Gum sores or ulcers
Children may also have difficulty eating or swallowing due to sore gums. Make sure to have any gum concerns evaluated promptly by a pediatric dentist or physician.
Acute Lymphoblastic Leukemia (ALL)
ALL is the most common childhood leukemia. The gum symptoms are typically severe pain, bleeding, ulcers and dramatic swelling. The abnormal lymphoblasts aggressively infiltrate the gums.
Acute Myeloid Leukemia (AML)
Childhood AML also causes significant gum problems like swelling, bleeding, sores and tenderness. However, it is far less common than ALL in children.
Seeking timely treatment is critical, as outcomes are better when childhood leukemia is caught early. So be very vigilant about gum symptoms in kids.
When to See a Doctor
Make sure to see a physician promptly if you notice any of the following gum changes:
- Ongoing bleeding from the gums
- Severely swollen or painful gums
- Gums that are numb, enlarged or firm
- Gum color changes – white, purple, red
- Gum sores or ulcers
- Unexplained gum symptoms
While gum problems are common, leukemia should be suspected if you have severe or persistent symptoms with no clear cause. See a doctor right away, especially if you have any other concerning symptoms like fatigue, bleeding or frequent infections.
Medical Treatments
Once leukemia is diagnosed, treatment focuses on destroying the cancerous cells. This helps resolve symptoms affecting the gums and rest of the body. Treatment options may include:
- Chemotherapy – Cytotoxic medications that kill cancer cells. Often used systemically or injected into the gums.
- Radiation – High energy beams to destroy cancer cells in the mouth. May be used if chemo doesn’t fully resolve gum lesions.
- Stem cell transplant – Restores healthy marrow and blood cells. Used in some cases after other treatments.
- Targeted therapy – Drugs that specifically attack cancer proteins and cells while minimizing overall toxicity.
The aim is to get the leukemia into remission, at which point the abnormal gum symptoms should subside.
Dental Care and Supportive Treatments
In addition to medical treatment, proper dental care can help manage symptoms affecting the mouth and gums:
- Palliative rinses – Rinses with lidocaine, milk of magnesia, or benzocaine can relieve mouth pain.
- Oral hygiene – Gentle brushing and flossing to prevent infection.
- Avoid irritants – Stop tobacco, alcohol, spicy foods.
- Protective gel – Gel coatings reduce friction and trauma.
- Antibiotics – Used both topically and systemically to treat secondary infections.
Make sure to let your dentist know about the leukemia diagnosis so they can provide tailored dental treatment as needed.
Prognosis
The prognosis for leukemia varies greatly depending on:
- Type of leukemia (ALL, AML, CLL etc)
- Stage and subtype
- Age of patient
- Response to treatment
With modern therapies, overall 5-year survival rates by type are:
- ALL (Acute Lymphoblastic Leukemia) – 75% adults, 90% children
- CLL (Chronic Lymphocytic Leukemia) – 84%
- CML (Chronic Myeloid Leukemia) – 66%
- AML (Acute Myeloid Leukemia) – 28% adults, 70% children
Early diagnosis and prompt treatment initiation are key to optimizing prognosis. Pay attention to abnormal gum symptoms, as they may provide the first warning sign of leukemia.
Prevention
In many cases, the cause of leukemia is unknown. But there are some measures that may help lower risk:
- Avoid tobacco use
- Minimize radiation exposure
- Use caution with chemicals like benzene
- Maintain a healthy weight
- Eat plenty of fruits and vegetables
There are also some inherited genetic conditions that raise leukemia risk. Talk to your doctor about genetic testing if you have a strong family history.
Conclusion
Leukemia can cause a number of changes in the appearance and health of the gums. Swelling, bleeding, pain, sores and color changes of the gums may signal that leukemia cells have infiltrated the tissue. While concerning, gum problems should be evaluated in the context of a full exam and testing panel to confirm a leukemia diagnosis. Proper medical treatment and dental care help manage gum symptoms and improve prognosis. Increased vigilance about oral changes is important, as gum abnormalities may provide the first sign that leukemia is developing.
