Dental Problems Following Surgery and External Radiation Therapy in Patients with Advanced Carcinomas of the Oral Cavity and Oropharynx

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

“…In six studies [12,24,30,31,34,36] the percentage of patients presenting with oral foci was described, ranging from 20% [30] to 79% [31]. Detailed information on the type of oral foci of infection found was provided in 6 studies [12,24,25,28,34,35] (Table 1).…”

“…Nine studies reported on the findings of the dental screening [12,24,25,28,30,31,[34][35][36] (Table 1). In six studies [12,24,30,31,34,36] the percentage of patients presenting with oral foci was described, ranging from 20% [30] to 79% [31].…”

“…Three papers were prospective [23][24][25], the others were retrospective [2,12,22,[26][27][28][29][30][31][32][33][34][35][36][37][38][39]. References of the 20 included studies were checked to find any additional relevant studies.…”

“…In 16 studies, oral hygiene instructions were given before the start of radiotherapy, either as part of the dental screening or early in the treatment process [2,12,[22][23][24][25][26][28][29][30][31][32]35,36,38,39]. Dental calculus removal was described as part of the dental screening or as a procedure early in the treatment process in 12 studies [12,22,[24][25][26][27][28][29]31,33,36,38].…”

“…Four of the studies provided a very precise description of what was assumed to be a focus of infection, such as ''caries in which excavation may lead to pulpal exposure'' [12,26,34,35], but other studies lacked adequate detail in the descriptions. They used more general terms such as ''active moderate periodontal disease'' [37] or ''advanced/severe periodontal disease'' without defining the severity of periodontitis [22][23][24][26][27][28][29][30][31][32][34][35][36][37][38].…”