IADR Abstract Archives
Post-Radiotherapy Dental Caries in Head and Neck Cancer Patients – an Observational Cohort Study.
Objectives: This ongoing prospective cohort study aims to investigate potential variation in the incidence of dental caries after head and neck cancer (HANC) patients have been treated with radiotherapy.
Methods: The longitudinal study commenced in the School of Dentistry, Belfast, Northern Ireland, in December 2018. Eligible patients with a clinical diagnosis of HANC were assessed and rendered dentally fit prior to radiotherapy (baseline assessment) including provision of high fluoride (5,000ppm) toothpaste. They were then followed up at 6-, 12-, and 24-months post-radiotherapy. Oral health data were collected at each visit via a combination of clinical dental assessments and validated patient-administered questionnaires.
Results: Data from 85 patients who attended at least one follow-up appointment by August 2021 is presented (n=85). Due to the COVID-19 pandemic, data from 6- and 12-month post-radiotherapy dental assessments were pooled. The mean age of the recruited sample was 58.9 (SD 10.0) years, and 71.8% (n=61) were male. The most common cancer sites under treatment were the oropharynx (n=33), oral cavity (n=16), and larynx (n=15). Approximately half (45.9%) of HANC patients presented with new carious lesions 6-12 months post-radiotherapy. The mean number of teeth affected by caries was 3.7 (SD 4.1). Approximately one-third (31.8%) of patients also had periodontitis 6-12 months post-radiotherapy. Patients with: (i) higher mean plaque scores (p=0.002), (ii) more severe xerostomia (p=0.007), (iii) fewer teeth (p=0.037), and (iv) continued intake of prescribed high-sugar dietary supplements (p=0.049), were more likely to develop post-radiotherapy dental caries.
Conclusions: Post-radiotherapy HANC patients experience high levels of dental caries. Poor oral hygiene, xerostomia, fewer teeth, and the continued intake of prescribed high-sugar dietary supplements after radiotherapy, may increase the risk of dental caries in these patients.
Methods: The longitudinal study commenced in the School of Dentistry, Belfast, Northern Ireland, in December 2018. Eligible patients with a clinical diagnosis of HANC were assessed and rendered dentally fit prior to radiotherapy (baseline assessment) including provision of high fluoride (5,000ppm) toothpaste. They were then followed up at 6-, 12-, and 24-months post-radiotherapy. Oral health data were collected at each visit via a combination of clinical dental assessments and validated patient-administered questionnaires.
Results: Data from 85 patients who attended at least one follow-up appointment by August 2021 is presented (n=85). Due to the COVID-19 pandemic, data from 6- and 12-month post-radiotherapy dental assessments were pooled. The mean age of the recruited sample was 58.9 (SD 10.0) years, and 71.8% (n=61) were male. The most common cancer sites under treatment were the oropharynx (n=33), oral cavity (n=16), and larynx (n=15). Approximately half (45.9%) of HANC patients presented with new carious lesions 6-12 months post-radiotherapy. The mean number of teeth affected by caries was 3.7 (SD 4.1). Approximately one-third (31.8%) of patients also had periodontitis 6-12 months post-radiotherapy. Patients with: (i) higher mean plaque scores (p=0.002), (ii) more severe xerostomia (p=0.007), (iii) fewer teeth (p=0.037), and (iv) continued intake of prescribed high-sugar dietary supplements (p=0.049), were more likely to develop post-radiotherapy dental caries.
Conclusions: Post-radiotherapy HANC patients experience high levels of dental caries. Poor oral hygiene, xerostomia, fewer teeth, and the continued intake of prescribed high-sugar dietary supplements after radiotherapy, may increase the risk of dental caries in these patients.