title: Influence of preventive dental treatment on mutans streptococci counts in patients undergoing head and neck radiotherapy.
abstract: The aim of this study was to evaluate the influence of chlorhexidine gluconate, sodium fluoride and sodium iodine on mutans streptococci counts in saliva of irradiated patients.
  
  
  METHODS
  Forty-five patients were separated into three experimental groups and received chlorhexidine (0.12%), sodium fluoride (0.5%) or sodium iodine (2%), which were used daily during radiotherapy and for 6 months after the conclusion of the treatment. In addition, a fourth group, composed by 15 additional oncologic patients, who did not receive the mouthwash or initial dental treatment, constituted the control group. Clinical evaluations were performed in the first visit to dental clinic, after initial dental treatment, immediately before radiotherapy, after radiotherapy and 30, 60, 90 days and 6 months after the conclusion of radiotherapy. After clinical examinations, samples of saliva were inoculated on SB20 selective agar and incubated under anaerobiosis, at 37ºC for 48 h. Total mutans streptococci counts were also evaluated by using real-time PCR, through TaqMan system, with specific primers and probes for S. mutans and S. sobrinus.
  
  
  RESULTS
  All preventive protocols were able to reduce significantly mutans streptococci counts, but chlorhexidine gluconate was the most effective, and induced a significant amelioration of radiotherapy side effects, such as mucositis and candidosis.
  
  
  CONCLUSIONS
  These results highlights the importance of the initial dental treatment for patients who will be subjected to radiotherapy for head and neck cancer treatment.
authors.affiliation: Department of Pathology and Clinic Propedeutics, School of Dentistry of Araçatuba, UNESP.
authors.forename: Lívia Buzati
authors.initials: LB
authors.lastname: Meca
authors.forename: Fátima Regina Nunes de
authors.initials: FR
authors.lastname: Souza
authors.forename: Helio Massaioshi
authors.initials: HM
authors.lastname: Tanimoto
authors.forename: Alvimar Lima de
authors.initials: AL
authors.lastname: Castro
authors.forename: Elerson
authors.initials: E
authors.lastname: Gaetti-Jardim Júnior
mesh_terms: D000328:Adult; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D002327:Cariostatic Agents / Q000627:therapeutic use; D002710:Chlorhexidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D015169:Colony Count, Microbial; D003731:Dental Caries / Q000517:prevention & control*; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009910:Oral Hygiene / Q000592:standards*; D016133:Polymerase Chain Reaction; D011878:Radiotherapy / Q000009:adverse effects; D012463:Saliva / Q000382:microbiology; D012969:Sodium Fluoride / Q000627:therapeutic use; D012974:Sodium Iodide / Q000627:therapeutic use; D018709:Statistics, Nonparametric; D013295:Streptococcus mutans / Q000187:drug effects* / Q000302:isolation & purification; D013997:Time Factors; D055815:Young Adult
chemical_list: D000891:Anti-Infective Agents, Local; D002327:Cariostatic Agents; D012969:Sodium Fluoride; D012974:Sodium Iodide; C010882:chlorhexidine gluconate; D002710:Chlorhexidine