A Case of Multiple Caries After Head and Neck Chemoradiotherapy and Difficulty with Oral Management

• Published in: Shika Hoshasen Vol. 61; no. 2; pp. 53 - 57
• Main Authors: Aragaki, Tadanobu, Yoda, Tetsuya, Kobayashi, Daijiro, Katsura, Kouji, Kurabayashi, Tohru, Kitamoto, Yoshizumi, Michi, Yasuyuki
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society for Oral and Maxillofacial Radiology 2022; 特定非営利活動法人 日本歯科放射線学会
• Subjects: dental management; head and neck chemoradiotherapy; late oral adverse events; radiation induced dental caries; 放射線性う蝕; 晩期口腔有害事象; 歯科管理; 頭頸部化学放射線治療
• ISSN: 0389-9705; 2185-6311
• DOI: 10.11242/dentalradiology.61.53

Introduction: Radiation-induced dental caries is a late oral adverse event that should be considered after head and neck radiotherapy. However, there are no clinical guidelines for dental management after head and neck radiotherapy. We report a case of multiple dental caries that developed after head and neck radiotherapy in a patient in whom symptomatic treatment was challenging. 　Case: A 67-year-old male was referred to our department with difficulty with oral intake secondary to occlusal insufficiency. He had a history of radiotherapy for hypopharyngeal carcinoma, and nearly all of his teeth only had residual roots. We found multiple carious teeth, including in areas outside of the radiation field. We designed a temporary denture in coordination with a dental office; however, it was difficult to extract all of the patient’s teeth. The patient was followed-up; however, he died of esophageal cancer. 　Conclusion: Radiation-induced dental caries can even occur in teeth outside of the radiation field. In such cases, continuous preventative measures, such as oral care, are important, even before the start of radiotherapy.