The patients with cariogenic high-risk after the cervico-facial radiotherapy and their management

Studying through clinical and laboratory means the bucco-dental status of the 28 patients who followed radiotherapeutical cures in the cervico-facial territory, the authors establish the apparition, at different periods of time, of the rampant caries. The rampant caries have been found in 46.42 percent of the cases, especially in patients exposed to prolonged or repeated cures of cervico-facial radiotherapy (88.88 percent) and concern the cervical zones, incisal edges and cusps, zones that are usually resistant at caries. The appearance and the severity of these types of caries are correlated with: a) the degree of reduction of the repose and stimulated salivary flow; b) the maintaining time of the low salivary flow that is dependent on the received X-ray dose and the number of cures; c) the association with sweet-drinks intake; d) the manner of effectuation of the bucco-dental hygiene; e) the setting-up or not of the some prevention measures. There are presented some preventive measures that must be set-up in this category of patients and treatment-protocols, that can be applied in the clinical situations of appearance of rampant caries after the irradiant treatment of the head and neck. The authors recommend the compulsory use of the prophylactic treatment and suggest a suitable plan of treatment that includes the reduction of microbial flora, the change of the alimentary diet, and salivary stimulates and substitutes. These measures can avoid the apparition of rampant caries, which will require ample restoration. The conclusions emphasize the fact that exists real possibilities of protection and treatment for these types of caries, depending on the clinical status of patient and the disease prognosis, when exists a tight collaboration between the radiotherapist, patients, and dentist.