title: Dental demineralization and caries in patients with head and neck cancer.
abstract: Concurrent chemoradiation (CCR) therapy is a standard treatment for patients with locally advanced head and neck cancer (HNC). It is well documented that CCR causes profound acute and late toxicities. Xerostomia (the symptom of dry mouth) and hyposalivation (decreased salivary flow) are among the most common treatment side effects in this cohort of patients during and following treatment. They are the result of radiation-induced damage to the salivary glands. Patients with chronic hyposalivation are at risk for demineralization and dental cavitation (dental caries), often presenting as a severe form of rapidly developing decay that results in loss of dentition. Usual post-radiation oral care which includes the use of fluoride, may decrease, but does not eliminate dental caries associated with radiation-induced hyposalivation. The authors conducted a narrative literature review regarding dental caries in HNC population based on MEDLINE, PubMed, CLNAHL, Cochrane database, EMBASE, and PsycINFO from 1985 to 2014. Primary search terms included head and/or neck cancer, dental caries, dental decay, risk factor, physical symptom, physical sequellea, body image, quality of life, measurement, assessment, cost, prevention, and treatment. The authors also reviewed information from National Institute of Dental and Craniofacial Research (NIDCR), American Dental Association (ADA), and other related healthcare professional association web sites. This literature review focuses on critical issues related to dental caries in patients with HNC: potential mechanisms and contributing factors, clinical assessment, physical sequellea, negative impact on body image and quality of life, potential preventative strategies, and recommendations for practice and research in this area.
authors.affiliation: School of Nursing, Vanderbilt University, Nashville, TN, United States. Electronic address: jie.deng@vanderbilt.edu.
authors.forename: Jie
authors.initials: J
authors.lastname: Deng
authors.affiliation: Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, TN, United States.
authors.forename: Leanne
authors.initials: L
authors.lastname: Jackson
authors.affiliation: Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles Ca and Division of Otolaryngology and Head and Neck Surgery, City of Hope National Medical Center, Duarte, CA, United States.
authors.forename: Joel B
authors.initials: JB
authors.lastname: Epstein
authors.affiliation: Department of Diagnostic Sciences and Oral Medicine, College of Dentistry, University of Tennessee Health Sciences Center, Memphis, TN, United States.
authors.forename: Cesar A
authors.initials: CA
authors.lastname: Migliorati
authors.affiliation: Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, TN, United States.
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Murphy
mesh_terms: D059248:Chemoradiotherapy / Q000009:adverse effects*; D003731:Dental Caries / Q000139:chemically induced / Q000150:complications*; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006801:Humans; D011788:Quality of Life; D011832:Radiation Injuries; D012307:Risk Factors; D017001:Tooth Demineralization / Q000139:chemically induced / Q000150:complications; D014987:Xerostomia / Q000139:chemically induced / Q000150:complications*
keywords: Decay; Dental caries; Dental demineralization; Head and neck cancer; Prevention; Radiation caries; Radiation therapy; Review