An update on the effects of radiation therapy and dental management of head and neck cancer patients

Abstract

Defects in the maxillofacial region may result in cosmetic, functional and psychological impairment which can have far reaching effects on patients’ quality of life. Head and neck cancer may be treated with a variety of modalities including surgical resection, chemotherapy and radiation therapy. Ionising radiation destroys tumour cells, rendering them less able to divide, and thereby halting tumour progression, but also destroys many normal cells leaving patients with a number of oral and/or facial side effects, some of which develop quickly and others only becoming evident after some time. This paper will review these complications and the effects they have on patient functionally, aesthetically and psychosocially. It will also propose ways in which dentists can be part of the multidisciplinary team who try to prevent, reduce or manage post radiation sequalae, and help restore patients’ dignity, functioning and general quality of life. The topic of osseointegrated implants in irradiated bone is a much debated, complex and controversial issue. This will be addressed in a follow-up review.