A cytotoxic antibiotic.

Paediatric cancers.

Dactinomycin causes bone marrow suppression with an accompanying

thrombocytopenia and agranulocytosis. Bone marrow suppression

can lead to troublesome oral ulceration, exacerbation of an

existing periodontal condition, and rapid spread of any residual (e.g.

periapical) infections.

The effect of dactinomycin on the bone marrow is transient and

routine dental treatment is best avoided until the white blood cells

and platelet counts start to recover. If emergency dental treatment

such as an extraction is required then antibiotic cover may be necessary

depending on the degree of myelosuppression. If the platelet

sutured. Persistent bleeding may require a platelet transfusion.

Patients on chemotherapeutic agents such as dactinomycin often

neglect their oral hygiene and thus there could be an increase in both

caries and periodontal disease. If time permits, patients about to go

on chemotherapy should have a dental check up and any potential

areas of infection should be treated. Similarly, to reduce the mucosal

irritation (sensitivity) that often accompanies chemotherapy, it is

advisable to smooth over rough cusps or restorations.

None of any dental significance.