Prophylactic and

Therapeutic Approaches

in Patient Undergoing

Radiotherapy

- A Dentists Perspective

Presented by,
Dr. Jomi Porinchu,
M. S. Ramaiah Dental College, Bangalore
The Dentists Role
Effects of Radiation
Changes in Biological Molecules
 Tissue Reactions to
Radiotherapy

1.Early Reactions within 3 to 9

weeks

2.Late Reactions beyond 12

weeks
Modes of Radiotherapy

1.External Beam Radiotherapy

2.Interstitial Irradiation /
Brachytherapy

3.Combined External Beam

and Brachytherapy
Radiation Induced
Complications

ChangeComplications
Infections
Disguesia
Oral
Acute in Saliva Composition
 Chronic
Complications
Pre-radiation Dental
Evaluation and Treatment
Evaluation
a. Patient history
b. Extra and Intraoral Clinical Examination
c. Radiographs
d. Salivary Gland Function
e. Other considerations:
i. Mode of therapy
ii. Radiation fields and
dose
iii.Urgency of treatment

Treatment Plan:
a. Oral hygiene maintenance.
b. Periodontal Prophylactic therapy
c. Extraction of non salvageable teeth
d. Restoration of teeth with dental caries
Dental Consideration During
Radiotherapy
Radiation Mucositis
Dysgeusia / Taste Loss
Infections and Role of Antiviral and Antifungal Drugs
Xerostomia/Hyposalivation
Radiation Caries
Postradiation
Osteonecrosis
Hyperbaric Oxygen Therapy Chamber
TMJ Disorders / Trismus
Postradiation Dental
Prophylaxis
Oral Hygiene and Treatment
 Conclusion

Dentist another
musician
orchestrating relief
 References
White and Pharaoh - Oral Radiology Principles and
Interpretation. 5th Ed
John Glaholm - Radiation and Chemotherapy
A. Vissink, F. R. Burlage, F. K. L. Spijkervet, J. Jansma and
R. P. Coppes - Prevention and Treatment of the Consequen
Of Head and Neck Radiotherapy, Crit. Rev. Oral Bio. Med.
2003; 14; 213
R. Atri, AK Dhull, V Nair, R Dhankhar, V Kaushal - Orodenta
Care related to Radiotherapy for Head and Neck Cancer.
JOHCD 2007;1(3):59-62
Nectarios Andrews, Chris Griffiths - Dental Complications
Head and Neck Radiotherapy : Part 2. Australian Dental
Journal 2001;46(3):174-182
Dr. T. W. Chow, Dr. K. C. Tse, Dr. Gordon F. C. Ho. - Dental
Care of Irradiated Patients
 References contd
Shenoy VK, Shenoy KK, Rodrigues S, Shetty P Manageme
of Oral Health in Patients Irradiated for Head and Neck
Cancer : A review. Kathmandu University Medical Journal
(2007), Vol 5, No. 1, Issue 17, 117-120
DH Koga, JV Salvajoli, FA Alves Dental Extractions and
Radiotherapy in Head and Neck Oncology: Review of the
Literature. Oral Diseases (2008) 14, 40-44
Hlya, ankaya and Pelin Gneri Importance of a
Dental Approach in Head and Neck Cancer Therapy
APJOH 2010; 2(1). February 2010
Acknowledgements
Dr. Yashoda Devi, Head of Department,
Department of Oral Medicine and
Radiology, MSRDC

Dr. Pushpanjali, Head of Department ,

Department of Public Health Dentistry,
MSRDC

Dr. Sujata, Professor, Department of Oral

Medicine and Radiology, MSRDC

Family and Friends

Thank You