Treatment and maintenance of a dentate patient with 'radiation caries'

Patients with xerostomia are presenting dental practitioners with challenges in caries control, long-term restoration and prosthodontic difficulties. In many cases, extraction may be the best option, but for younger, dentate patients, this may be inappropriate. This paper describes the management of a young partially dentate patient with severe xerostomia following irradiation of the salivary glands. Preventive and restorative management are discussed, together with treatment and healing of peri-radicular pathology. The case report demonstrates that long-term stabilization and management of caries and peri-radicular lesions are possible over a seven-year period for a patient with severe radiation caries.

Many dental patients present with some degree of xerostomia due to age, side-effects of anti-hypertensive and psychotropic drugs and also as a side-effect of radiotherapy. General dental practitioners are ideally placed to monitor and provide early intervention for this highly caries-susceptible group of patients. With good patient motivation and professional support, tooth loss is not inevitable and this case report suggests strategies and demonstrates the clinical stages in the management of severe caries due to xerostomia.