IADR Abstract Archives
The effect of dental and salivary gland radiation dose on the occurrence of post-radiotherapy dental disease in patients with head and neck cancer.
Objectives: This observational study aimed to investigate variation in the incidence of dental caries and periodontitis among post-radiotherapy head and neck cancer (HANC) patients.
Methods: The study commenced in December 2018 in the Centre for Dentistry, Belfast. Eligible patients with HANC were assessed and rendered dentally fit prior to radiotherapy (baseline assessment), including provision of high fluoride (5,000ppm) toothpaste. Patients were then followed-up at 6-months and 12-months post-radiotherapy. Oral health data were collected at each visit via clinical dental assessment and validated patient-administered questionnaires. The radiation dose exposures of the teeth and salivary glands were determined by a blinded assessor.
Results: Data from 151 patients that attended for follow-up is presented (n=151).The mean age of the recruited sample was 59.3 (standard deviation (SD) 10.4) years, and 74.2% (n=112) were male. Approximately half (49.0%) of patients presented with new carious lesions 6-12 months post-radiotherapy. The mean number of carious teeth was 3.7 (SD 4.1). Approximately one-third (31.8%) of patients were diagnosed with periodontitis 6-12 months post-radiotherapy. Multivariate statistical tests including logistic regression revealed that patients with: (i) continued intake of high-sugar dietary supplements (p≤0.020), (ii) daily dietary consumption of tea/coffee with added sugar (p≤0.023), and (iii) the presence of pre-radiotherapy dental caries (p≤0.012), had an increased odds of post-radiotherapy dental caries. At the dental sextant level (n=644), a 10-unit increase in both mean (p≤0.027) and maximum (p≤0.006) dental radiation dose (Gray) were associated with a 26-32% increase in the odds of post-radiotherapy dental caries after adjusting for other variables. Contrastingly, the radiation dose exposures of the teeth and parotid glands were found to have no effect on the incidence of post-radiotherapy periodontitis (p>0.05).
Conclusions: Post-radiotherapy HANC patients experience high levels of dental disease. Increased dental radiation dose, previous caries experience, and the continued intake of prescribed high-sugar dietary supplements after radiotherapy, may increase patients’ risk of post-radiotherapy dental caries.
Methods: The study commenced in December 2018 in the Centre for Dentistry, Belfast. Eligible patients with HANC were assessed and rendered dentally fit prior to radiotherapy (baseline assessment), including provision of high fluoride (5,000ppm) toothpaste. Patients were then followed-up at 6-months and 12-months post-radiotherapy. Oral health data were collected at each visit via clinical dental assessment and validated patient-administered questionnaires. The radiation dose exposures of the teeth and salivary glands were determined by a blinded assessor.
Results: Data from 151 patients that attended for follow-up is presented (n=151).The mean age of the recruited sample was 59.3 (standard deviation (SD) 10.4) years, and 74.2% (n=112) were male. Approximately half (49.0%) of patients presented with new carious lesions 6-12 months post-radiotherapy. The mean number of carious teeth was 3.7 (SD 4.1). Approximately one-third (31.8%) of patients were diagnosed with periodontitis 6-12 months post-radiotherapy. Multivariate statistical tests including logistic regression revealed that patients with: (i) continued intake of high-sugar dietary supplements (p≤0.020), (ii) daily dietary consumption of tea/coffee with added sugar (p≤0.023), and (iii) the presence of pre-radiotherapy dental caries (p≤0.012), had an increased odds of post-radiotherapy dental caries. At the dental sextant level (n=644), a 10-unit increase in both mean (p≤0.027) and maximum (p≤0.006) dental radiation dose (Gray) were associated with a 26-32% increase in the odds of post-radiotherapy dental caries after adjusting for other variables. Contrastingly, the radiation dose exposures of the teeth and parotid glands were found to have no effect on the incidence of post-radiotherapy periodontitis (p>0.05).
Conclusions: Post-radiotherapy HANC patients experience high levels of dental disease. Increased dental radiation dose, previous caries experience, and the continued intake of prescribed high-sugar dietary supplements after radiotherapy, may increase patients’ risk of post-radiotherapy dental caries.