Oral manifestations of acute leukemia in children: family supernatural beliefs and its contribution to the prognosis of the disease

Abstract

Aim: This case report aims to elaborate on the oral manifestations of acute leukemia in children and the extent to which the family’s supernatural beliefs contributed to the prognosis of the disease. Background: Leukemia is a malignancy of hematopoietic cells, and about 56% of cases are manifest in the oral cavity. In Indonesia, cancer is among diseases often related to a supernatural phenomenon that may hinder the patient from getting medical treatment. Case Description: An 8-year-old girl was referred to the Oral Medicine Department due to swollen and bleeding gums. There was generalized enlargement of the gingiva with a reddish-purple color covered 2/3 of the dental crown and easy to bleed. The patient was diagnosed with gingival enlargement and gum bleeding due to acute leukemia as the suspected underlying disease. The patient was scheduled for a bone marrow aspiration examination to confirm the blood disorder diagnosis, but the family refused it and believed that supernatural power was the cause of the cancer. Conclusion: Gingival enlargement and spontaneous bleeding of the gum are often the first oral signs of acute leukemia. Considering the influence of supernatural beliefs in society regarding cancer is still existing, dentists are required to be more persistent in educating patients and their families to receive definitive therapy to increase patient life expectancy. Clinical Significance: The oral manifestation of leukemia should be treated promptly to support the systemic therapeutic. Delay in diagnosis and treatment will lead to poor outcomes of the disease.