title: Comparison of dental health of patients with head and neck cancer receiving IMRT vs conventional radiation.
abstract: OBJECTIVE
  To analyze the dental health of patients with head and neck cancer who received comprehensive dental care after intensity-modulated radiation therapy (IMRT) compared with radiation therapy (RT).
  
  
  METHODS
  Historical cohort study.
  
  
  METHODS
  Veteran Affairs (VA) hospital.
  
  
  METHODS
  In total, 158 patients at a single VA hospital who were treated with RT or IMRT between 2003 and 2011 were identified. A complete dental evaluation was performed prior to radiation treatment, including periodontal probing, tooth profile, cavity check, and mobility. The dental treatment plan was formulated to eliminate current and potential dental disease. The rates of dental extractions, infections, caries, mucositis, xerostomia, and osteoradionecrosis (ORN) were analyzed, and a comparison was made between patients treated with IMRT and those treated with RT.
  
  
  RESULTS
  Of the 158 patients, 99 were treated with RT and 59 were treated with IMRT. Compared with those treated with IMRT, significantly more patients treated with RT exhibited xerostomia (46.5% vs 16.9%; P < .001; odds ratio [OR], 0.24; 95% confidence interval [CI], 0.11-0.52), mucositis (46.5% vs 16.9%; P < .001; OR, 0.24; 95% CI, 0.11-0.52), and ORN (10.1% vs 0%; P = .014; OR, 0.07; 95% CI, 0.00-1.21). However, significantly more patients treated with IMRT were edentulous by the conclusion of radiation treatment (32.2% vs 11.1%; P = .002; OR, 3.8; 95% CI, 1.65-8.73).
  
  
  CONCLUSIONS
  Patients who were treated with IMRT had fewer instances of dental disease, more salivary flow, and fewer requisite posttreatment extractions compared with those treated with RT. The number of posttreatment extractions has been reduced with the advent of IMRT and more so with a complete dental evaluation prior to treatment.
authors.affiliation: Department of Head and Neck Surgery, David E. Geffen School of Medicine at UCLA, Los Angeles, California, USA.
authors.forename: Victor M
authors.initials: VM
authors.lastname: Duarte
authors.forename: Yuan F
authors.initials: YF
authors.lastname: Liu
authors.forename: Sassan
authors.initials: S
authors.lastname: Rafizadeh
authors.forename: Tracey
authors.initials: T
authors.lastname: Tajima
authors.forename: Vishad
authors.initials: V
authors.lastname: Nabili
authors.forename: Marilene B
authors.initials: MB
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003731:Dental Caries / Q000209:etiology; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D052016:Mucositis / Q000209:etiology; D010025:Osteoradionecrosis / Q000209:etiology; D010353:Patient Education as Topic; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects; D012189:Retrospective Studies; D009057:Stomatognathic Diseases / Q000209:etiology* / Q000517:prevention & control; D014987:Xerostomia / Q000209:etiology
keywords: IMRT and dental; dental health; radiation and dental health