Dental needs in brazilian patients subjected to head and neck radiotherapy

Abstract

In spite of its recognized benefits in the treatment of malignant tumors, radiation therapy have several side effects in the head and neck region. The evaluation of oral conditions by a dentist is important to prevent or minimize these problems. The aim of this retrospective review was to analyze the dental needs in 357 patients who received radiotherapy in the head and neck region and were treated at Orocentro/FOP/UNICAMP, between January 1990 and December 2004. Review of patient files showed that dental examination before radiotherapy was not performed in 148 patients (41.5%) and was done in 209 patients (58.5%). From the total of examined patients, 94 (45%) did not require dental procedures at the moment of examination, while 115 (55%) presented some sort of dental need. Following the patients after the radiotherapy, it was observed that the group of patients that was evaluated before radiation presented less need of restorations, root canal filling and dental extractions than those who were not evaluated. The results of this study confirm that the evaluation of oral conditions prior to radiotherapy is essential to minimize the dental needs, emphasizing the importance of the dentist in the multidisciplinary team that treats cancer patients.

Preradiotherapy dental extractions and health-related quality of life

“…This is in keeping with the literature showing head and neck cancer patients present with high dental needs and unmanaged risk factors, poor oral health literacy and low engagement with the dental profession, often persisting post-treatment [4,15,16]. 15.5% (20) of those having pre-RT dental extractions went on to have post-RT dental extractions, with only 10 participants having post-RT extractions alone.…”

Evidence supporting pre-radiation elimination of oral foci of infection in head and neck cancer patients to prevent oral sequelae. A systematic review

“…Nevertheless, pre-radiation dental screening of patients is daily practice in head and neck cancer centers [7,8]. Head and neck oncology patients are known to have poor dental status compared to healthy subjects [9][10][11][12]. The poorer dental status is thought to be related to the more frequent alcohol and tobacco abuse and lower dental awareness in these patients.…”

Pre-radiotherapy dental extractions and osteoradionecrosis: a retrospective analysis and cross-sectional study on quality of life

“…This is in keeping with the literature showing head and neck cancer patients present with high dental needs and unmanaged risk factors, poor oral health literacy and low engagement with the dental profession, often persisting post-treatment [13,25,92]. 15.5% (20) of those having pre-RT dental extractions went on to have post-RT dental extractions, with only 10 participants having post-RT extractions alone.…”

“…Firstly, the time interval between decision to treat and the initiation of radiotherapy is often short, meaning treatment must be prompt. Secondly, recently diagnosed HNC patients have a relatively high prevalence of dental disease [13,25], with one study showing only 11% of patients did not require pre-radiotherapy dental care [26] 19 and up to 50% requiring at least one extraction [13]. Scaling, prophylaxis and fluoride application should be performed and where simple restorations are required these should be carried out before radiotherapy begins.…”