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National Journal of Maxillofacial Surgery
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Year : 2015  |  Volume : 6  |  Issue : 2  |  Page : 160-166

Radiation-induced dental caries, prevention and treatment - A systematic review

1 Department of Conservative Dentistry and Endodontics, PDM Dental College and Research Institute, Bahadurgarh, Haryana, India
2 Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
3 Department of Radiation Oncology, SGPGI, Lucknow, Uttar Pradesh, India

Correspondence Address:
Dr. Manoj Pal
Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0975-5950.183870

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Treatment of head and neck cancers (HNCs) involves radiotherapy. Patients undergoing radiotherapy for HNCs are prone to dental complications. Radiotherapy to the head and neck region causes xerostomia and salivary gland dysfunction which dramatically increases the risk of dental caries and its sequelae. Radiation therapy (RT) also affects the dental hard tissues increasing their susceptibility to demineralization following RT. Postradiation caries is a rapidly progressing and highly destructive type of dental caries. Radiation-related caries and other dental hard tissue changes can appear within the first 3 months following RT. Hence, every effort should be focused on prevention to manage patients with severe caries. This can be accomplished through good preoperative dental treatment, frequent dental evaluation and treatment after RT (with the exception of extractions), and consistent home care that includes self-applied fluoride. Restorative management of radiation caries can be challenging. The restorative dentist must consider the altered dental substrate and a hostile oral environment when selecting restorative materials. Radiation-induced changes in enamel and dentine may compromise bonding of adhesive materials. Consequently, glass ionomer cements have proved to be a better alternative to composite resins in irradiated patients. Counseling of patients before and after radiotherapy can be done to make them aware of the complications of radiotherapy and thus can help in preventing them.

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