Onkologie. 2021:15(2):54-57 | DOI: 10.36290/xon.2021.010

The importance of dental treatment before radioterapy of head and neck cancer

Nima Mahdian¹, Jiří Holakovský¹, Anna Onderková², Barbora Mahdianová³

¹ Maxilofaciální chirurgie, Stomatologická klinika VFN a 1. LF UK, Praha

² 1. lékařská fakulta Univerzity Karlovy v Praze

³ Stomatologická klinika dětí a dospělých 2. LF UK a FN Motol, Praha

Radiotherapy is a very important part of the treatment of head and neck tumors. However, this treatment method brings with it a number of side effects resulting from the harmful effects of radiation on tissues and organs in the maxillofacial region. The tissues affected include the major and minor salivary glands, the mucous membranes of the oral cavity, the teeth, the skin and muscles of the head, neck and upper chest, as well as the bones in the irradiated area. Impairment of these structures is clinically manifested by xerostomia, mucositis, and/or a loss of taste. Post-radiation caries, trismus, and skin burns may also develop. However, perhaps the most severe complication of radiotherapy of the head and neck is osteoradionecrosis. It is a very serious, difficult-to-treat disease to which the jaw bones are most susceptible; however, in various forms we also encounter it in other bones that have been exposed to a radiation dose (cheekbone, frontal or temporal bone. We also encounter osteoradiomyelitis of spinal vertebrae). It is important to keep in mind that these complications impact patients' overall management and worsen their quality of life. In some cases, they lead to the cessation of the primary cancer treatment. With the proper management, these side effects can be alleviated or completely prevented. The purpose of this text is to provide a summary of current recommendations for the preparation of this subset of patients with head and neck malignancies before radiotherapy and their subsequent management from a dental perspective.

Keywords: head and neck cancer, radiotherapy, chemoradiotherapy, osteoradionecrosis, maxillofacial surgery, quality of life.

Published: April 29, 2021  Show citation