Common oral complications of head and neck cancer radiation therapy: mucositis, infections, saliva change, fibrosis, sensory dysfunctions, dental caries, periodontal disease, and osteoradionecrosis

• Published in: Cancer medicine (Malden, MA) Vol. 6; no. 12; pp. 2918 - 2931
• Main Authors: Sroussi, Herve Y, Epstein, Joel B., Bensadoun, Rene‐Jean, Saunders, Deborah P., Lalla, Rajesh V., Migliorati, Cesar A., Heaivilin, Natalie, Zumsteg, Zachary S.
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.12.2017; John Wiley and Sons Inc
• Subjects: Clinical Cancer Research; Communicable Diseases - diagnosis; Communicable Diseases - etiology; Communicable Diseases - therapy; Dental caries; Dental Caries - diagnosis; Dental Caries - etiology; Dental Caries - therapy; Fibrosis; Gum disease; Head & neck cancer; head and neck cancer; Head and Neck Neoplasms - pathology; Head and Neck Neoplasms - radiotherapy; Humans; neurosensory disorder; oral candidiasis; oral health; Oral hygiene; oral mucositis; Osteoradionecrosis - diagnosis; Osteoradionecrosis - etiology; Osteoradionecrosis - therapy; Periodontal Diseases - diagnosis; Periodontal Diseases - etiology; Periodontal Diseases - therapy; Periodontics; Radiation therapy; Radiotherapy - adverse effects; Review; Risk Factors; Salivation - radiation effects; Sensation Disorders - diagnosis; Sensation Disorders - etiology; Sensation Disorders - physiopathology; Sensation Disorders - therapy; Stomatitis - diagnosis; Stomatitis - etiology; Stomatitis - therapy; Treatment Outcome; oral mucositis; head and neck cancer; Fibrosis; oral candidiasis; radiation therapy; neurosensory disorder; oral health
• ISSN: 2045-7634; 2045-7634
• DOI: 10.1002/cam4.1221

Patients undergoing radiation therapy for the head and neck are susceptible to a significant and often abrupt deterioration in their oral health. The oral morbidities of radiation therapy include but are not limited to an increased susceptibility to dental caries and periodontal disease. They also include profound and often permanent functional and sensory changes involving the oral soft tissue. These changes range from oral mucositis experienced during and soon after treatment, mucosal opportunistic infections, neurosensory disorders, and tissue fibrosis. Many of the oral soft tissue changes following radiation therapy are difficult challenges to the patients and their caregivers and require life‐long strategies to alleviate their deleterious effect on basic life functions and on the quality of life. We discuss the presentation, prognosis, and management strategies of the dental structure and oral soft tissue morbidities resulting from the administration of therapeutic radiation in head and neck patient. A case for a collaborative and integrated multidisciplinary approach to the management of these patients is made, with specific recommendation to include knowledgeable and experienced oral health care professionals in the treatment team. Oral complications of radiation therapy to the head and neck can result in acute and long‐term deterioration in oral soft tissues and dentition. The presentation, prognosis, and strategies to manage the dental and nondental morbidities of radiation therapy to the head and neck are discussed in this manuscript.