Management of salivary hypofunction during and after radiotherapy.

Abstract

Salivary hypofunction, the most common complication of high-dose radiation therapy (RT) to the head and neck, has a significant impact on quality of life, and requires careful planning of long-term dental and oral care. This report documents the results and conclusions of an evidence-based literature review on multidisciplinary team management of salivary hypofunction during and after RT. An update is provided on the pathophysiology of salivary hypofunction during and after RT, and recommendations for clinical management. The paper presents aspects managed by dental professionals (use of cholinergic agonists and other saliva stimulants, prevention of hyposalivation-induced rampant caries, and use of saliva substitutes), as well as the role of the radiation oncologist in minimizing salivary gland damage (parotid-sparing RT; cytoprotectants). This summary includes basic science, translational and clinical research topics with respect to radiation-induced salivary hypofunction, and provides an evidence-based management algorithm.

• Authors: Caroline H Shiboski, Tim A Hodgson, Jonathan A Ship, Morten Schiødt
• Journal: Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics (Oral Surg Oral Med Oral Pathol Oral Radiol Endod) Vol. 103 Suppl Pg. S66.e1-19 (Mar 2007) ISSN: 1528-395X [Electronic] United States
• PMID: 17379158 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Review)

Chemical References

• Muscarinic Agonists
• Radiation-Protective Agents
• Saliva, Artificial
• Pilocarpine
• Amifostine

Topics

• Amifostine (adverse effects, therapeutic use)
• Dental Caries (prevention & control)
• Humans
• Muscarinic Agonists (therapeutic use)
• Pilocarpine (therapeutic use)
• Radiation Injuries (therapy)
• Radiation-Protective Agents (therapeutic use)
• Radiotherapy (adverse effects)
• Saliva, Artificial (therapeutic use)
• Salivary Glands (radiation effects, transplantation)
• Xerostomia (etiology, physiopathology, therapy)