The effect of chemotherapy on the supragingival plaque of pediatric cancer patients.

The anaerobic cultivable flora of the dental plaque was investigated in 16 cancer children at days 0, 7, 14 and 21 of a first cure of chemotherapy. Results were compared with those obtained in 16 healthy children. Diseased children showed more quantitative variations of the flora than the controls, especially during the first week of chemotherapy. Whatever the day of sampling, the flora of the diseased children was significantly less complex than that of the controls. Viridans streptococci, Capnocytophaga, and to a lesser extent staphylococci, appeared to be the most strongly affected in diseased children. This could be explained by different mechanisms, uncontrolled recolonization of the dental plaque, selection of multidrug-resistant strains or nosocomial acquisition. These results indicate that variations in quantity, complexity and quality of the oral flora occur during chemotherapy, leading to a major imbalance of the ecosystem.