Oral Complications From the Treatment of Oral Cavity and Oropharyngeal Cancers

ABSTRACT

Background: Patients with oral cavity and oropharyngeal cancer (OC/OP) often develop treatmentassociated complications in the oral cavity. Dentists play a significant role in recognizing and managing treatment-associated oral complications of OC/OP.

Methods: Utilizing a combination of the latest published literature, clinical guidelines and textbooks, we summarized the short- and long-term oral complications that can arise in patients undergoing treatment for oral cavity/oropharyngeal cancers and provide dental treatment guidelines for oral health practitioners.

Results: Treatment-associated side effects for OC/OP cancers include both acute and chronic toxicities. Short-term complications include oral mucositis, infections, bleeding, immune-related adverse events and taste disturbances. Long-term complications include osteoradionecrosis, salivary gland dysfunction, dental caries, trismus, neuropathic pain and secondary cancers.

Conclusions: Continued improvements in treatment methods for OC/OP cancers have increased the average life expectancy after diagnosis. However, the sequelae of oral complications following treatment for OC/OP cancers is complex and often has a significant impact on patients’ quality of life.

Practical implications: Dental providers have an important role in the evaluation and management of patients’ oral health before, during and following treatment for OC/OP cancers.

Key words::

• Head and neck cancer
• oral cavity cancer
• oropharyngeal cancer
• oral toxicities
• dental oncology
• xerostomia
• osteoradionecrosis
• oral irAE
• mucositis
• oral oncology

Additional information

Notes on contributors

Karen He

Karen He, BA, is a predoctoral dental student (DMD) at the Harvard School of Dental Medicine in Boston. Conflict of Interest Disclosure: None reported.

Trevor G. Hackman

Trevor G. Hackman, MD, is a professor and vice chair, inpatient operations and quality, and the director of the head and neck fellowship, department of otolaryngology/head and neck surgery at the University of North Carolina School of Medicine in Chapel Hill, N.C. Conflict of Interest Disclosure: None reported.

Siddharth Sheth

Siddharth Sheth, DO, is an assistant professor in the department of medical oncology at the University of North Carolina School of Medicine in Chapel Hill, N.C. Conflict of Interest Disclosure: None reported.

Bhishamjit S. Chera

Bhishamjit S. Chera, MD, is an associate professor and the associate chair of clinical operations and improvement and the director of patient safety and quality, department of radiation oncology at the University of North Carolina School of Medicine in Chapel Hill, N.C. Conflict of Interest Disclosure: Dr. Chera holds ownership interest (including patents) in and is a consultant/advisory board member for Naveris Inc.

Muhammad A. Shazib

Muhammad Ali Shazib, DMD, is an assistant professor and medical director of UNC Hospitals Oral Medicine Services, division of craniofacial and surgical care at the University of North Carolina, Adams School of Dentistry, Chapel Hill, N.C. Conflict of Interest Disclosure: None reported.