Radiation therapy of the oral cavity: Sequelae and management, part 2

Abstract

This is the concluding portion of a two-part series dealing with the effects and manifestations in the oral cavity of radiation therapy of head and neck tumors. Preradiation and postradiation extractions in dentulous patients, as well as dental maintenance of such patients (including fluoride treatments follow-up, and restorative care), are discussed. Guidelines for the dental management of edentulous patients are also presented at length (this section covers risk of bone necrosis, soft liners, timing of denture placement, dentures and preexisting bone necrosis, soft-tissue necrosis and dentures, morbidity, and prosthodontic procedures). The article concludes with a brief discussion of osteoradionecrosis and soft-tissue necrosis.

Evaluation of radiation-induced Class V dental caries in patients with head and neck cancers undergoing radiotherapy

“…The majority of patients experience severe xerostomia. 7 The present study addressed the radiotherapy-induced dental caries in patients with head and neck malignancies, in whom the salivary glands were in the radiation field. The results showed that the rate of dental caries 3 weeks after the initiation of treatment and at the end of treatment was statistically higher than the rate before treatment.…”

Dental Management of the Geriatric Head and Neck Cancer Patient1

“…A dental examination prior to radiation therapy attempts to recognize and mitigate any of the potential sources of complications. Beumer et al [1979] found that some of the unfortunate but inevitable destructive effects on the oral cavity may include: mucositis, xerostomia, candidiasis, ageusia, caries, trismus and osteoradionecrosis.…”

Dental management and prosthetic rehabilitation of patients with head and neck cancer

“…The minimal precaution taken should be antibiotic coverage, and, as with preirradiation extractions, sharp bone edges should be carefully trimmed because the normal balance between osteoclastic and osteoblastic activity is disturbed by irradiation. 2 The extraction site should be sutured to promote primary healing. The number of extractions should be limited to two or three teeth at any one time.…”