Navigating the dental landscape: Periodontal and microbiological considerations in head and neck cancer patients undergoing radiation therapy.

Abstract

Author(s): Rachita G Mustilwar, Nazia Khan, Zameer Pasha, Anish Nelson, Tushar Bhople, Patruni Sai Prasanna, Kunal Shankarrao Deshmukh

Head and Neck Cancer (HNC) patients undergoing Radiation Therapy (RT) face unique challenges with potential impacts on oral health and overall well-being. This study focuses on the crucial role of periodontal considerations in their comprehensive care. It aims to provide an overview of periodontal implications associated with radiation therapy and evidence-based recommendations for dental management. RT, while effective against HNC, often induces adverse effects on oral tissues such as xerostomia, mucositis, and radiation-induced periodontitis. These conditions heighten susceptibility to periodontal infections, significantly affecting patients' oral health-related quality of life. This study synthesizes research findings, clinical guidelines, and expert consensus to offer a framework for periodontal assessment, treatment planning, and maintenance in this population. Emphasis is placed on pre-RT dental evaluation as a critical foundation for minimizing radiation-induced complications. Strategies for prevention and management of periodontal complications are discussed, including personalized oral hygiene protocols, antimicrobial therapies, and adjunctive interventions to mitigate radiation-induced damage. Furthermore, in HNC patients undergoing RT, the microbiological aspect is pivotal in understanding and managing periodontal health. RT induces significant alterations in the oral microbiome, leading to dysbiosis characterized by shifts in microbial composition and increased colonization of pathogenic species. These changes create a favourable environment for the proliferation of opportunistic pathogens, potentially exacerbating periodontal disease. This article also emphasizes the interdisciplinary nature of care, highlighting the collaboration between oncologists, radiation oncologists, microbiologists, and dental professionals in optimizing patient outcomes. It underscores the importance of patient education and empowerment in maintaining oral health throughout the radiation therapy journey.

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