Management of Oral Hygiene in Head-Neck Cancer Patients Undergoing Oncological Surgery and Radiotherapy: A Systematic Review

Abstract

Background: In the literature, among oral health prevention programs dedicated to cancer patients, a wide heterogeneity is evident. The purpose of this work is to analyze the available scientific evidence for the treatment of head and neck cancer (HNC) patients undergoing resective surgery and radiotherapy and to draw up a diversified oral hygiene protocol during oncological therapy. Methods: PubMed was used as database. Studies published from 2017 to September 2022 were analyzed. Studies investigating the effectiveness of the preventive procedures carried out by the dental professionals in HNC patients undergoing postoperative adjuvant therapy have been taken into account. Results: The application of the search string on PubMed allowed the selection of 7184 articles. The systematic selection of articles led to the inclusion of 26 articles in this review, including 22 RCTs, 3 observational studies, and 1 controlled clinical study. Articles were divided according to the debated topic: the management of radiation-induced mucositis, xerostomia, the efficacy of an oral infection prevention protocol, and the prevention of radiation-induced caries. Conclusions: Dental hygienists are fundamental figures in the management of patients undergoing oncological surgery of the maxillofacial district. They help the patient prevent and manage the sequelae of oncological therapy, obtaining a clear improvement in the quality of life.

Efficacy of Ceragenins in Controlling the Growth of Oral Microorganisms: Implications for Oral Hygiene Management

“…This observation provides solid evidence to support the potential use of ceragenin-based mouthwashes in oral care scenarios, including everyday oral hygiene and particularly for patients after surgical procedures or those experiencing hypersensitivity resulting from oral mucosa damage and local inflammation. Particularly, the group of cancer patients, including those head and neck cancer patients receiving radiation therapy or chemotherapy and thus, suffering from oral mucositis [ 56 ], might strongly benefit from these features of ceragenins.…”

Dental caries and demineralization in head and neck cancer patients undergoing radiotherapy

“…Depending on the type and location of the lesion, maxillary cancer surgery often includes the hard palate, maxillary sinus, and nasal cavity. 59 After surgical procedures, some patients may need to use maxillofacial prostheses. The main objectives of using maxillofacial prostheses are to restore oral functions and enhance facial aesthetics and the patient's quality of life.…”

“…To minimize the risk of dental and periodontal problems due to difficulty in maintaining oral hygiene, good hygiene education is essential. 59 Patients should pay attention to the following for maintaining oral hygiene: 60…”

Treatment Complications of Head and Neck Cancers and Rehabilitation Measures: A Narrative Review

“…The dental hygienist significantly promotes personal care to enhance the patient's QoL. They help patients achieve good oral hygiene, remove tartar deposits that can lead to infection, maintain healthy oral mucosa, and educate patients on how to handle treatment-related issues and equip them with the necessary tools for prevention [ 58 ].…”

“…The maintenance program involves encouraging and instructing patients on oral hygiene, conducting routine oral mucosal health check-ups, and providing professional oral hygiene services every three months. In summary, managing oral hygiene in patients with HNC requires a collaborative approach between dental hygienists, oncologists, and other healthcare professionals [ 58 ]. This approach ensures patients receive the specialized care and support necessary to maintain their oral health and well-being.…”