Protocol for the prevention and treatment of oral sequelae resulting from head and neck radiation therapy

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Abstract
In addition to the desired antitumor effects, head and neck radiation therapy induces damage in normal tissues that may result in oral sequelae such as mucositis, hypo-salivation, radiation caries, taste loss, trismus, soft-tissue necrosis, and osteoradionecrosis. These sequelae may be dose-limiting and have a tremendous effect on the patient's quality of life, Current policies to prevent these sequelae primarily are based on clinical experience and show great diversity. A protocol for the prevention and treatment of oral sequelae resulting from head and neck radiation therapy, based on fundamental research and data derived from the literature, is presented. The protocol is particularly applicable in centers with a dental team. This team should be involved at the time of initial diagnosis so that a successful preventive regimen is an integral part of the overall cancer treatment regimen.