Pretreatment oral health care interventions for radiation patients

Individuals undergoing head and neck radiation treatments and cytotoxic chemotherapy for cancer are at risk for a variety of deleterious oral side effects. This added potential for oral problems places the cancer patient in a special category for oral health care management. Pretreatment intervention regimens directed at the supporting tissues of the teeth can effectively remove dental calculus deposits and cementum-imbedded bacterial toxins and reverse the inflammatory state of the periodontium back to normal. A variety of patient-applied fluoride agents are extremely effective in preventing severe radiation-associated dental decay, which is likely to occur after salivary gland dysfunction. Deficiencies in current patient management protocols and areas of current research are noted. Two essentials for a successful patient management program are emphasized: early referral of the patient to a knowledgeable dental team to ensure pre-cancer treatment oral health care intervention and long-term maintenance, and a family-oriented education and motivation program to enhance patient understanding and compliance.