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Cancer Med. 2017 Dec;6(12):2918-2931. doi: 10.1002/cam4.1221. Epub 2017 Oct 25.

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

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Division of Oral Medicine & Dentistry, Brigham and Women's Hospital, Boston, MA.
Samuel Oschin Comprehensive Cancer Instititue, Cedars-Sinai Medical Center, Los Angeles, CA.
Division of Otolaryngology and Head and Neck Surgery, Duarte, California.
Centre de Haute Energie, 10, Bd Pasteur, 06000, Nice, France.
Department of Dental Oncology, Health Sciences North, Northeastern Cancer Centre, Sudbury, Ontario, Canada.
Northern Ontario School of Medicine, Rm 42036, Sudbury, Ontario, P3E 5J1, Canada.
Section of Oral Medicine, University of Connecticut Health, Farmington, Connecticut.
Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida, Gainesville, Florida.
Oral Maxillofacial Surgery Department, University of California, San Francisco, California.
Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, California, 90048.


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.


Fibrosis; head and neck cancer; neurosensory disorder; oral candidiasis; oral health; oral mucositis; radiation therapy

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