RADIATION CARIES IN PATIENTS WITH HEAD AND NECK CANCER: LITERATURE REVIEW

Cancer is a heterogeneous group of diseases marked by the uncontrolled proliferation of abnormal cells. Among the most prevalent malignancies in the head and neck region are oral and laryngeal cancers, which often require radiotherapy as part of their treatment. While effective, radiotherapy induces local and systemic side effects, including radiation-induced caries—a rapidly progressing and destructive condition affecting about 30% of head and neck cancer patients. Unlike conventional caries, radiation caries typically begins on smooth surfaces and cemento-enamel junctions, leading to severe crown destruction often without significant pain. It is a multifactorial disease, with primary causes including hyposalivation, decreased salivary pH, and structural damage to enamel and dentin due to radiation-induced free radicals. Contributing factors include trismus, poor oral hygiene, and dietary shifts towards soft, carbohydrate-rich foods. Preventive and therapeutic strategies require a proactive approach from dental professionals, emphasizing rigorous oral hygiene, daily fluoride rinses, artificial saliva, and interim restorations with fluoride-releasing materials such as glass ionomer cements. Definitive restorations using composite resins may be compromised by changes in oral tissues post-radiotherapy. A multidisciplinary team—including dentists, nutritionists, and oncologists—plays a crucial role throughout the cancer care process. Early diagnosis and management of radiation caries are essential to preserve dental structures and ensure the patient's quality of life. This literature review aimed to explore the prevalence, pathophysiology, clinical features, prevention, and management of radiation caries in patients undergoing radiotherapy for head and neck cancers, highlighting the importance of comprehensive dental care in oncologic settings.