Dental management of patients with radiotherapy to the head and neck cancers

Patients,  undergoing radiotherapy, as primary, adjuvant or complex treatment of  head and neck cancer are prone to a number of dental complications. Radiatiotherapy is a technique that uses ionizing radiation with a therapeutic effect due to the semi-selective damage to genetic material of cancer cells in a direct way or through the production of free radicals, leading to cell death. The adverse effects of radiotherapy appear to damage normal cells, especially those that divide quickly and are less prone to regeneration. In the oral cavity that can be cells of the oral mucosa, underlying soft tissues, teeth, periosteum, bone cells, glands and blood vessels. Changes lead to specific radiation syndromes. These include xerostomia and dysgeusia occurring of damage to the salivary glands, oral mucositis in damage to epithelial cells, pathological changes in the normal microflora radiation-induced caries, limited mouth opening due to changes in the structure of collagen and osteonecrosis due to decreased bone healing potential.

Strategies for prevention and management of such complications could be controversial.

This lecture is aimed at highlighting the current understanding and management of dental needs of the patient before, during and after radiotherapy.