Abstract
Head and neck cancer patients need to receive dental care previously to radiotherapy. Even patients who regularly visit dental offices need special attention including prophylactic and curative treatments. The purposes of this study were to evaluate the dental status of Brazilian head and neck squamous cell carcinoma patients with low socioeconomic level as well as to discuss the dental treatment performed and the oral side effects of radiotherapy. Forty patients with head and neck squamous cell carcinoma received dental care and dental extractions prior to radiotherapy and were were followed up for a mean period of 28.7 months after the cancer treatment. Before radiotherapy, 28 patients were dentulous and 12 edentulous, and all of them had poor oral health and hygiene. The most common treatment performed were dental extraction and 23 patients had 8.6 teeth extracted on average. One out of 9 (11.1%) patients developed radiation caries and 5 out of 23 cases (21.3% - Group I) developed osteoradionecrosis, being only 1 case associated with previous dental extraction. Brazilian low-socioeconomic level patients with head and neck cancer were submitted to multiple dental extractions due to poor dental conditions and inadequate oral care. The dental treatment did not prevent osteoradionecrosis, which presumably presented a multifactorial etiology in most cases.
Highlights
Patients with head and neck squamous cell carcinoma elected to radiotherapy need to receive preventive dental treatment
Dental extractions and periodontal treatment prior to radiotherapy prevent the development of radiation caries, progression of periodontal disease and osteoradionecrosis [4,5]
Forty patients with head and neck squamous cell carcinoma submitted to radiotherapy were recruited from the Center Specialized in Oncology (CEON) in the city of Piracicaba, Brazil, and enrolled in this study
Summary
Patients with head and neck squamous cell carcinoma elected to radiotherapy need to receive preventive dental treatment. A study with 250 patients examined just before radiotherapy showed that 68% of them needed immediate dental care [1]. Even patients who regularly visit dental offices need specific dental care before radiotherapy, including dental extractions [2]. It is desired that patients achieve a good level of oral hygiene before radiotherapy [3]. Dental extractions and periodontal treatment prior to radiotherapy prevent the development of radiation caries, progression of periodontal disease and osteoradionecrosis [4,5]. It is well accepted that tooth extraction should be avoided even after many years of head and neck radiotherapy [6]
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