[Dental care in patients undergoing radiotherapy of the head and neck]

Radiotherapy involving the oral cavity and salivary glands induces a wide range of alterations in oral tissues and salivary gland functions which may result in oral side effects. Some of these are inevitable and transient such as radiation mucositis, some however may be permanent such as xerostomia. Others however are preventable, and are caused by poor radiation techniques, application of excessive radiation doses or lack of necessary preventive measures. Frequent complications in these patients are development of caries, dental hypersensitivity, rapidly progressive periodontal disease and loss of taste. Occasionally, trismus and osteoradionecrosis may develop. Careful treatment planning before start of radiotherapy with adequate dosimetry and careful shielding of the healthy tissues as well as close monitoring of the oral cavity with strict application of preventive measures (dental care protocol) can significantly reduce the incidence of these complications. The private practitioner should keep in mind the life-long precautions that are necessary when treating these patients.