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Madhusudhan Reddy M*
Department of Oral Pathology and Microbiology, Lenora Institute of Dental Sciences, Rajanagaram, Rajamundry, East Godavari, Andhrapradesh-533101, India, Email:
*Correspondence: Madhusudhan Reddy M, Department of Oral Pathology and Microbiology, Lenora Institute of Dental Sciences, India, Tel: 08832484492, Email:

Citation: Madhusudhan Reddy M. Oral Health Protocol for Head and Neck Cancer Survivors. Ann Med Health Sci Res. 2017; 7: 52-53

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Cancer is one of the major menaces to public health in both developed and developing countries accounting for the second most common cause of death. World Health Report 2004 reveals that cancer accounted for 7.1 million deaths in 2003 and it is estimated to increase by 50% in the next 20 years. Oral cancer is the third most common cancer in south-central Asia. The incidence of this disease in India is 12.6 per 100000 populations. Cancer risk factors include ageing, tobacco, unhealthy diet, physical inactivity and infections. [1]. 90% of the oral cancers are due to use of tobacco, excessive consumption of alcohol and areca nut. [1,2].

Treatment options based on stages of the cancer and therapies given to treat include surgery with or without neck dissection, radiotherapy, chemotherapy or combination of the treatments. [3,4].

Head and Neck Cancer (HNC) survival has improved in recent decades with advances in treatment. HNC survivor’s growth is continuous and alarming the challenges in management of complex medical, oral/dental and physcosocial needs of them. [5]. Complications of head and neck cancer and their management is explained in the Table 1. [6-8].

Complications Symptoms and Management
Mucosal Mucositis: Continuous follow up and evaluation by dental professionals, healing promotion by administering proinflammatory cytokines, prevention of trauma to the mucosa by using soft brushes
Pain: Administration of analgesics based on the pain severity,
Dysphagia: Induce salivation, artificial saliva
Saliva changes Viscousity: Mucolytic agents
Volume: administering Sialogogues causing Serous secretions
Neurosensory Neuropathic pain: Local topical analgesics, Systemic anticonvulsant and anti-depression drugs
Dental/periodontal Acute exacerbation of chronic infection: evaluation and elimination of the risk factors before commencement of the cancer therapy
Mucosal Candida: local and systemic antifungal drugs based on the severity of the infection
Herpes: antiviral drugs
Mucosal pain Atrophy:  Attention to hyposalivation, mucosal infection and mucositis
Neuropathy: Systemic anticonvulsant and anti-depression drugs, severe conditions opioid analgesics
Saliva Viscousity: Mucolytic agents, hydrogen peroxide mouth rinse
Hyposalivation: Sialogogues
Neurosensory Taste alteration, taste loss: manage oral infection, oral hygiene, xerostomia and zinc supplementation
Halitosis: Maintenance of oral hygiene
Trismus: Active and passive exercise following surgical procedure
Mucosal Pain: Administration of analgesics based on the pain severity
Halitosis: Maintenance of oral hygiene
Dental Demineralization, caries: fluoride tooth pastes, topical calcium phosphate, fluoride, xylitol, chlorhedine gluconate rinse and gums or wafers
Periodontal Advanced attachment loss, mobility: identify and address the risk factors prior to the cancer therapy
Necrosis Osteoradionecrosis: Antibiotics, surgery including sequestrectomyerapy, hyperbaric oxygen, ozone therapy

Table 1: Oral complications of head and neck cancer therapy and management.

Sound knowledge about the oral complication and their management of head and neck cancer treatment will help the dentists to provide best appropriate oral and dental care helping to lead good quality of life.

Conflict of Interest

All authors disclose that there was no conflict of interest.


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