Radiotherapy Flashcards
What is the primary mechanism by which radiotherapy destroys cells?
Radiotherapy destroys DNA
Which types of cells are most affected by radiotherapy?
Hematopoietic/blood cells, epithelial/skin cells, and endothelial/intestinal cells.
Which organs are most subject to effects of radiotherapy in mouth? Why?
Oral mucosa
Salivary glands
Bone
TMJ joints
(Blood)
What is a common complaint related to taste during early radiotherapy treatment?
Loss of the sense of taste.
What treatment may provide relief for severe mucositis?
Viscous lidocaine may be useful.
What long-term changes occur in the oral mucosa after radiotherapy?
Predisposition to breakdown, delayed healing, thin and less keratinized epithelium, and submucosal fibrosis.
What is trismus and how does it relate to radiotherapy?
Trismus is decreased ability to open the mouth due to inflammation and fibrosis of the pterygomasseteric sling and periarticular connective tissues.
What is xerostomia?
Decreased production of saliva leading to dry mouth.
List some adverse sequelae of loss of salivary function due to radiotherapy.
- Difficulty tasting
- Difficulty chewing
- Difficulty swallowing
- Difficulty sleeping
- Nutritional compromises
- Increased incidence of oral infections
What protective roles does saliva play in the oral cavity?
- Antibacterial properties
- Protection against wear
- Antifungal properties
- Part of the innate immune system
What is the most feared side effect of radiotherapy in dental patients?
Osteoradionecrosis.
What should be done with teeth that have a questionable or poor prognosis before radiotherapy?
They should be extracted.
What pre-treatment procedures should be performed on the dentition before radiotherapy?
- Thorough prophylaxis
- Topical fluoride application
- Inspection for pathologic conditions
- Rounding of sharp cusps
How often should patients be seen by the dentist during radiotherapy?
Each week.
What type of rinses should patients use during radiation treatment?
- Saline rinses at least 10 times a day
- Chlorhexidine mouth rinses twice a day
