Oral and dental health in head and neck cancer survivors.

Firoozeh Samim,Joel B Epstein,Zachary S Zumsteg,Allen S Ho,Andrei Barasch

doi:10.1186/s41199-016-0015-8

Firoozeh Samim, Joel B Epstein + Show 3 more

Open Access

https://doi.org/10.1186/s41199-016-0015-8

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Abstract

Therapeutic improvements and epidemiologic changes in head and neck cancer (HNC) over the last three decades have led to increased numbers of survivors, resulting in greater need for continuing management of oral and dental health in this population. Generally, the HNC patient oral health needs are complex, requiring multidisciplinary collaboration among oncologists and dental professionals with special knowledge and training in the field of oral oncology. In this review, we focus on the impact of cancer treatment on oral health, and the oral care protocols recommended prior to, during and after cancer therapy. The management of oral complications such as mucositis, pain, infection, salivary function, taste and dental needs are briefly reviewed. Other complications and their management, including osteonecrosis of the jaw and recurrent/new primary malignancies are also described. This review offers clinical protocols and information for medical providers to assist in understanding oral complications and their management in HNC patients and survivors, and their oral and dental health care needs. Oral and dental care is impacted by the patient’s initial oral and dental status, as well as the specific cancer location, type, and its treatment; thus, close communication between the dental professional and the oncology team is required for appropriate therapy.

Highlights

More than 600,000 cases of head and neck cancer (HNC) are diagnosed each year worldwide
This review focuses on the role of dental health care providers, and protocols of oral care in HNC patients
Post – Cancer Treatment o Monitoring, prevention and management of oral complications o Checking for cancer recurrence or secondary primary cancer o Dental caries prevention, periodontal maintenance o Determine frequency of dental hygiene follow-up interval based on level of hyposalivation, demineralization/caries rate and patient’s oral hygiene post-radiotherapy; patients with dry mouth, may require hygiene and recall every 3–4 months o Patient education o Fluoridated toothpaste; in high risk patients home fluoride trays daily o Good oral hygiene, soft toothbrushes or electric or ultrasonic brushes, flossing o Maintain lubrication of mouth and lips o Encourage non-cariogenic diet and cessation of tobacco & alcohol pathogenesis of the condition [25]

Summary

Background

More than 600,000 cases of HNC are diagnosed each year worldwide. With evolving etiologies and advances in treatment, HNC survival has improved in recent decades and the population of HNC survivors continues to grow [1]. Post – Cancer Treatment o Monitoring, prevention and management of oral complications (mucositis, dry mouth, mucosal pain, taste change, infection, dental demineralization, dental caries, periodontal disease, soft tissue/osteonecrosis etc.) o Checking for cancer recurrence or secondary primary cancer o Dental caries prevention, periodontal maintenance o Determine frequency of dental hygiene follow-up interval based on level of hyposalivation, demineralization/caries rate and patient’s oral hygiene post-radiotherapy; patients with dry mouth, may require hygiene and recall every 3–4 months o Patient education o Fluoridated toothpaste; in high risk patients home fluoride trays daily o Good oral hygiene, soft toothbrushes or electric or ultrasonic brushes, flossing o Maintain lubrication of mouth and lips o Encourage non-cariogenic diet and cessation of tobacco & alcohol pathogenesis of the condition [25].

Systemic analgesics

Management of specific oral complications related to HNC

Conclusion