Bhandari Sudhir, Soni Bhavita Wadhwa, Bahl Amit, Ghoshal Sushmita
Unit of Prosthodontics, Oral Health Sciences Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Department of Radiotherapy, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Spec Care Dentist. 2020 May;40(3):238-250. doi: 10.1111/scd.12469. Epub 2020 May 7.
The cumulative effect of radiation and the extent of related morbidities on oral tissues are enormous and increase over time. The numerous radiation-related side effects have a strong, negative influence on the oral functions and are responsible for a drastic reduction in the oral-health-related quality of life of the cancer survivors. In a significant deviation to the earlier approach of advising extraction of all remaining teeth before RT, the concept of preserving a maximum number of teeth in a state of health and for better oral functions postcancer cure has been globally accepted and is adhered to. The effects of radiation and their impact on the general well-being of the patients underscore the relevance of understanding the sequelae of radiation therapy on healthy oral tissues, preexisting oral diseases and their progression, impact on oral treatment needs, limitations in performing the indicated treatment, and shortcoming in treatment outcomes. It is vital for the professionals involved in head and neck cancer care to follow a well-devised referral system for oral care before and after RT and educate patients for a life-long follow-up.
辐射对口腔组织的累积效应以及相关发病率的程度是巨大的，且会随着时间增加。众多与辐射相关的副作用对口腔功能有强烈的负面影响，并导致癌症幸存者与口腔健康相关的生活质量大幅下降。与早期在放疗前建议拔除所有余留牙的方法有显著不同，在癌症治愈后保留最大数量健康牙齿以实现更好口腔功能的理念已被全球接受并得到遵循。辐射的影响及其对患者总体健康的作用凸显了了解放射治疗对健康口腔组织、既往口腔疾病及其进展、对口腔治疗需求的影响、进行指定治疗的局限性以及治疗结果缺陷的重要性。对于参与头颈癌护理的专业人员而言，在放疗前后遵循精心设计的口腔护理转诊系统并教育患者进行终身随访至关重要。
