Dental management of patients irradiated for oral cancer

Abstract

Management of patients irradiated for oral cancer should include consideration of their oral health prior to, and after, radiation therapy. Data from 130 patients, followed for a period of 1 to 10 years, are presented and evaluated. The philosophy of retention and maintenance of as many teeth as possible is supported by this data. Extraction of teeth with severe periodontal disease after irradiation also proves to be a relatively safe operation. Osteoradionecrosis tends to be limited in extent and is generally well tolerated by the patient when treated conservatively. A treatment regimen is presented that significantly reduces the morbidity from therapeutic irradiation of the jaws. A comprehensive dental evaluation and follow-up plan coupled with patient cooperation are instrumental to the success of this program.

Palliative Dental Care- A Boon for Debilitating

“…Precautions to be followed in averting complications of radiotherapy at hospice of head & neck cancer patients [43,44]:…”

Osteoradionecrosis of the mandible: A ten year single-center retrospective study

“…Concerning local pathological conditions, marginal periodontitis (Niewald et al, 1996, Jereczek-Fossa and Orecchia, 2002, Katsura et al, 2008, Oh et al, 2009) and denture irritation (Thorn et al, 2000, Oh et al, 2009 have been implicated in the development of ORN. The reason is that an open wound is present in the oral cavity during and after RT in these cases (Regezi et al, 1976, Murray et al, 1980a, 1980c, Beumer et al, 1984, Kluth et al, 1988, Bachmann et al, 1996, Katsura et al, 2008.…”

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

“…Some studies have shown that the lack of pre-radiotherapy extractions presents a risk factor for ORN [28], while other studies have found that preradiotherapy extractions are not beneficial in reducing rates of ORN regardless of tooth condition [20] and may actually increase the overall risk of ORN [4,18,21,22]. 20 If extractions are performed, it is important to allow sufficient healing time prior to the commencement of radiotherapy but not to unduly delay it.…”

“…We recommend that patients receive appropriate analgaesia for their pain, and are screened by a dietician to assess their oral intake. 21 …”

“…The incidence of some complications is associated with treatment factors, such as in the case of osteoradionecrosis and dental extractions [4,18,[20][21][22]. As oral complications are common, potentially preventable and 17 have iatrogenic factors, it is essential that those working with HNC patients be aware of the prevention and management of radiotherapy-related oral complications.…”