Radiotherapy and oral sequelae: preventive and management protocols.

The purpose of this paper is to provide background information on radiotherapy, and to present dental hygiene protocols for the treatment of head and neck radiation patients. These patients experience specific oral complications or sequelae that require specialized care. To assist the treating dental hygienist in understanding the genesis of these complications, a brief history of the use of radiotherapy and its effects on mammalian tissue is included. Complications may include mucositis, candidiasis, xerostomia, loss of taste, trismus, severe caries, nutritional deficit, and osteoradionecrosis. Management protocols are presented for the prevention and treatment of these complications. Maximum protocol effectiveness and long-term success may only be attained by education of and communication with the patient. As the number of head and neck radiation patients increases daily, a thorough understanding of the disease and treatment process is becoming more necessary for all oral healthcare providers.