The impact of radiation caries in the quality of life of head and neck cancer patients

Paglioni, Mariana de Pauli; Palmier, Natália Rangel; Prado‐Ribeiro, Ana Carolina; Fregnani, Eduardo Rodrigues; Gavião, Maria Beatriz Duarte; Brandão, Thaís Bianca; Lopes, Márcio Ajudarte; Ribeiro, Ana Paula Dias; Migliorati, Cesar A.; Santos‐Silva, Alan Roger

doi:10.1007/s00520-019-05171-8

Cited by 26 publications

(21 citation statements)

References 40 publications

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“…Inability to maintain optimal oral hygiene, shift of oral ora in favor of cariogenic organisms, dietary changes along with radiotherapy-induced xerostomia puts the patient at a higher risk of developing dental caries [24]. Our results related to statistically signi cant increase in DMFT scores in HNC patients, especially those treated with radiotherapy (de nite or adjuvant), corroborated the data published in a recent multi-centric study by Paglioni et al [25]. They concluded that radiation-caries was associated with higher DMFT scores and lower HRQoL scores.…”

Section: Discussionsupporting

confidence: 90%

Maximum incisal opening, caries experience and health-related quality of life in patients undergoing treatment for head and neck cancer – A longitudinal cohort study.

Dholam¹,

Somani²,

Dugad³

et al. 2021

Preprint

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Purpose Prospective evaluation of the change in maximum incisal opening (MIO) in patients receiving treatment for head neck cancer (HNC), and its interaction with clinical parameters such as tumor site/ sub-site and type of treatment received. Secondary aim was to ascertain the longitudinal change in dental caries experience and health-related quality of life (HRQoL) during the study period. Methods Seventy treatment-naïve patients undergoing treatment for squamous cell carcinoma (SCC) of oral cavity and/or oropharynx were assessed at 3 designated time-points; pre-treatment (T0), immediate post-treatment (T1) and 6-months post-treatment (T2). The primary study variable was change in MIO (cm) across 3 time points (T0, T1, T2). Dental caries incidence was measured using decayed, missing, filled teeth (DMFT) index and HRQoL was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaires (EORTC QLQ-C30 and H&N-35). Change in DMFT and HRQoL was assessed between T0 and T2. Non-parametric repeated measures ANOVA was used to analyse the longitudinal change in MIO and DMFT scores and their interaction with clinical parameters respectively. Wilcoxon signed-rank test was used to compare corresponding HRQoL domains between T0 and T2. All statistical tests were 2-sided, and differences with a p-value < 0.05 were considered statistically significant. Results Sixty-seven eligible HNC patients showed a significant change in mouth-opening and dental caries experience from T0 to T2, irrespective of tumor site/ sub-site and type of treatment (p < 0.001). Site-wise, patients with oral cavity cancer and specifically maxillary tumors; treatment-wise those undergoing surgery and/or, multi-modal treatment showed persistently reduced mouth opening late post-treatment. There was a statistical increase in head-and-neck site specific HRQoL symptoms at T2. A high prevalence (69%) of post-treatment trismus was noted especially in patients undergoing multi-modality treatment (83%). Conclusion Patients undergoing treatment for HNC demonstrate a significant longitudinal change in mouth-opening and caries incidence. They may show partial recovery of MIO at 6-months after an initial decrease in the immediate post-treatment period.

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Section: Discussionsupporting

confidence: 90%

Maximum incisal opening, caries experience and health-related quality of life in patients undergoing treatment for head and neck cancer – A longitudinal cohort study.

Dholam¹,

Somani²,

Dugad³

et al. 2021

Preprint

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“…Some studies that recorded the DMFT score after cancer therapy reported higher scores than those in the present study ( Joyston-Bechal et al, 1992 , Tezal et al, 2013 , Quispe et al, 2018 , de Pauli Paglioni et al, 2019 ), while others have reported lower DMFT scores ( Dreizen et al, 1977 , Schwarz et al, 1999 , Michelet, 2012 , Dholam et al, 2013 , Venkataraghavan et al, 2014 , Gupta et al, 2016 ). One study recording DMFT scores after cancer therapy reported results comparable to those in the current study ( Bachok, Biswal et al, 2018 ).…”

Section: Discussioncontrasting

confidence: 77%

Assessment of oral health and care in head and neck oncology patients in King Faisal Specialist Hospital and Research Center-Jeddah

Bundugji

Bafarat

Bundagji

et al. 2021

The Saudi Dental Journal

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Objectives To assess oral hygiene indices, dental status, and oral health practices among head and neck cancer patients at King Faisal Specialist Hospital and Research Center (KFSHRC)-Jeddah. Materials and Methods The charts of 117 patients with head and neck cancer were reviewed to identify the decayed/missing/filled teeth (DMFT) index, calculus index (CI), gingival index (MGI), and oral hygiene index. The type of cancer, other systemic diseases, and sex data were extracted from the records and analyzed using SPSS statistical software for descriptive statistics, Student’s t -test, analysis of variance (ANOVA), and Spearman correlation statistical analyses. Results The total mean DMFT index was 14.33. The significant caries index (SiC) for the studied sample was 25.87. Men had a mean DMFT of 14.11 (SD 9.8). The mean DMFT index for women was 14.63 (SD 9.7). The DMFT score for patients with systemic disease was 17.47 (SD 9.9). Patients with no other diseases had a mean DMFT score of 12.82 (SD 9.3). The DMFT index was not significantly different between men and women (p = 0.925). One-way ANOVA (F = 1.729) revealed no significant difference (p = 0.110) between DMFT scores according to the location of the cancer. DMFT with systemic disease showed no significant difference (p = 0.6) in comparison to patients without systemic disease. The Spearman rho statistic revealed no correlation between the DMFT score and CI (p = 0.383). Conclusions The total DMFT score was 14.33. The total SiC was 25.87. The DMFT scores of men and women were not significantly different. Cancer location and presence or absence of systemic diseases did not affect the DMFT score. The DMFT score and CI were not correlated, but a correlation was found between the DMFT score and MGI and the oral hygiene index.

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“…However, due to the complex anatomical characteristics of the head and neck, radiotherapy can adversely affect surrounding tissues include salivary glands, oral mucosa and dentition, leading to a series of side effects, such as hyposalivation, radiation caries and mucositis [ 3 ]. Radiation caries (RC) is a typical clinical symptoms response to radiotherapy, which can lead to aggressive tooth destruction [ 4 , 5 ], loss of masticatory efficiency, persistent chronic oral infections, and osteoradionecrosis (ORN) [ 6 ]. The changes of oral microbes after the radiation treatment have been considered as one of the etiological factors in the development of radiation caries [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Synonymous point mutation of gtfB gene caused by therapeutic X-rays exposure reduced the biofilm formation and cariogenic abilities of Streptococcus mutans

et al. 2021

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Background The shift of oral microbiota is a critical factor of radiation caries in head and neck cancer patients after the radiotherapy. However, the direct effects of irradiation on the genome and virulence of cariogenic bacteria are poorly described. Here we investigated the genomic mutations and virulence change of Streptococcus mutans (S. mutans), the major cariogenic bacteria, exposed to the therapeutic doses of X-rays. Results X-ray reduced the survival fraction of S. mutans and impacted its biofilm formation. We isolated a biofilm formation-deficient mutant #858 whose genome only possessed three synonymous mutations (c.2043 T > C, c.2100C > T, c.2109A > G) in gtfB gene. The “silent mutation” of c.2043 T > C in gtfB gene can cause the down-regulation of all of the gtfs genes’ expression and decrease the GtfB enzyme secretion without the effect on the growth due to the codon bias. #858 and synonymous point mutation strain gtfB2043 T>C, similar to the gtfB gene null mutant Δ gtfB, can significantly decrease the extracellular polysaccharide production, biofilm formation and cariogenic capabilities both in vitro and in vivo compared with wild type. Conclusion The direct exposure of X-ray radiation can affect the genome and virulence of oral bacteria even at therapeutic doses. The synonymous mutations of genome are negligent factors for gene expression and related protein translation due to the codon usage frequency.

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The impact of radiation caries in the quality of life of head and neck cancer patients

Cited by 26 publications

References 40 publications

Maximum incisal opening, caries experience and health-related quality of life in patients undergoing treatment for head and neck cancer – A longitudinal cohort study.

Maximum incisal opening, caries experience and health-related quality of life in patients undergoing treatment for head and neck cancer – A longitudinal cohort study.

Assessment of oral health and care in head and neck oncology patients in King Faisal Specialist Hospital and Research Center-Jeddah

Synonymous point mutation of gtfB gene caused by therapeutic X-rays exposure reduced the biofilm formation and cariogenic abilities of Streptococcus mutans

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