From 1986 to 1996, 6 patients who suffered from leukemia were found by oral manifestation in our department. Their initial symptoms and clinical courses were investigated. The results were as follows:
1) Gingival bleeding was the initial symptom in 3 patients with a diagnosis of chronic marginal periodontitis by the referring dentist. The diagnosis for one patient was oral candidiasis, and that for the other 2 patients was pericoronitis of lower third molar and suspect of odontogenic infection, respectively. Two patients had been treated surgically by scaling and incision.
2) The period from onset of symptoms until the first visit to our outpatient clinic was relatively short, with an average of 10 days.
3) The initial clinical diagnosis at our outpatient clinic was that 3 patients had leukemia and the other 3 patients had oral candidiasis, perimandibular abscess, malignant tumor, respectively. The patient with leukemia showed a remarkable bleeding tendency and general symptoms such as gingival bleeding, subcutaneous petechiae, paleness, severe general fatigue, fever and appetite loss. For gingival and mucosal bleeding, suture, compression, and gingival bandage were attempted, but local hemostasis was difficult. The diagnosis of leukemia could not be made for 3 patients because they did not show typical oral and general symptoms of leukemia.
4) Attention must be paid to some cases without typical oral and general symptons to diagnose leukemia as early as possible.