Consequences of hyposalivation in relation to cancer treatment and early management of radiation-induced caries: case reports

Given the prevalence of head and neck carcinoma and the salivary changes induced by the oral side effects of radiotherapy, such patients are at higher risk/susceptibility of developing dental caries. Radiation-caries is often under-treated in patients undergoing cervicofacial radiotherapy, yet these lesions can increase the risk of osteoradionecrosis due to necessary subsequent dental extractions. Moreover, xerostomia is accompanied by difficulties with speech, chewing and swallowing. The prevention and/or early management of radiation-induced carious lesions is essential in preventing oral complications and improving patients' quality of life. Based on a French case series, this paper proposes a protocol for the dental management of radiation-induced carious lesions. Demonstrates that patients receiving cervicofacial radiotherapy who develop hyposalivation should undergo active surveillance at an early stage in order to prevent/limit the progression of caries.Suggests that professional application of fluoride varnishes is an alternative to be considered if trays cannot be worn.Applying silver diamine fluoride during cancer treatment not only prevents the formation of new carious lesions, but also halts the progression of existing ones, particularly on proximal root surfaces where access is limited for diagnosis and restoration.