The type of cancer will indicate possible organ damage or dysfunction. Side effects should also be anticipated if XRT was given in combination with chemotherapy or if full body radiation was rendered.
The most common head and neck cancer treated with XRT is squamous cell carcinoma.
Oral health care differs greatly before radiation, during radiation, and after radiation.
XRT in the mouth area is associated with numerous oral complications, such as xerostomia, candidiasis, mucositis, radiation caries, and possibly osteoradionecrosis.
XRT affecting the bone marrow may be associated with pancytopenia, making the patient susceptible to infections and impaired hemostasis.
XRT of the chest may cause radiation-induced heart disease.
The amount of radiation is commonly reported in centigrays (cGy)
(1 cGy = 1 rad; 1 Gy = 100 rads).
Increased radiation doses will cause increased levels of changes to both normal and neoplastic tissue.
For squamous cell carcinoma a radiation dose of 5,000-7,500 cGy is given.
The XRT can be given in one daily dose of 200 cGy for 5-8 weeks or fractionated in two daily 100 cGy doses.
Accumulated doses below 4,000 cGy are associated with fewer oral complications.
If dental care is to be performed during XRT, it should be planned according to the XRT schedule.
Oral changes may be temporary during XRT, or damaged tissue may cause permanent long-term complications.
These complications are usually directly related to the amount of centigrays received in the affected area and how the radiation was delivered. Fractionated dosing may be associated with an increased prevalence of oral complications (see Sroussi HY, et al. below).
- Medical Disorders
- Oral Health Care Considerations