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Adverse effects of radiotherapy on oral tissues: A review

Shwetha Nambiar K, Vanishri C Haragannavar, Dominic Augustine, SV Sowmya, Roopa S Rao



Oral cancer is a major health problem in developing countries like India that is attributed mainly due to tobacco chewing habit. Oral squamous cell carcinoma (OSCC) accounts to about 90% of all oral cancers and holds 3rd place in South Central Asia. OSCC is managed by surgery, radiotherapy, or chemotherapy, or a combination of any of these modalities. Radiotherapy is a part of cancer treatment where high doses of radiation are delivered to large areas of oral cavity that includes the lesional areas as well as surrounding structures. This may result in several undesired reactions that manifest during or after the completion of therapy. The acute and chronic effects of radiation on oral tissues are discussed in detail here. The irreversible damage caused to the oral tissues is related to the dosage of radiation, the field of irradiation, the degree of hypovascularity/hypocellularity of tissues, the age of the patient, and the wound healing capacity. Majority of the patients undergoing treatment have a compromised quality of life as a side effect of radiation therapy. Hence, in-depth knowledge of radiation exposure, adequate dosage, modality, general state, and prognosis of each case is essential to evaluate personalized treatment plan. The severity of the complications can be minimized by implementing oral care protocols before, during, and after radiation therapy. A multidisciplinary treatment plan with dental surgeons, radiotherapists, speech therapists, nutritionists, and psychologists is required for patient management.


Mucositis; oral cancer; osteoradionecrosis; taste dysfunction; trismus; xerostomia

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