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Background: This research was aimed to critically evaluate, under the light of the available scientific evidence, the
oral care protocols recommended by different hospitals in head and neck cancer (HNC) patients under radiation
therapy.
Material and Methods: A questionnaire requesting all the relevant information for the oral care of these patients was
sent to the 9 University Hospitals in Madrid. The answers were categorized and analyzed. In addition, an electronic
search was conducted to identify the most relevant papers (systematic reviews [SR] and randomized clinical trials
[RCTs]) assessing oral care protocols for patients treated for HNC with radiation therapy.
Results: Eight out of nine centers answered the questionnaire and the retrieved information was tabulated and
compared. These recommendations were analyzed by a computerized search on MEDLINE and the Cochrane Oral
Health Collaboration Database. The results of the analysis clearly shown a great heterogeneity, in terms of oral
health care protocols, regarding the management of irradiated patients (for HNC) within the Hospitals of Madrid
region. In addition, some of the recommendations lack solid scientific support.
Conclusions: The present survey revealed that the recommendations provided by the different hospitals were clearly
different. The available evidence, supported by SR and RCTs, suggested the need of an oral assessment before cancer treatment, in order to prevent and treat dental pathologies and avoiding potential complications; during cancer
treatment, it is relevant monitoring the patient in order to decrease the severity of the side effects, and to avoid
any tooth extraction or surgery and special attention should be paid to mucositis, xerostomia and candidiasis; after
cancer treatment, the following are relevant aspects: the risk of osteoradionecrosis, trismus, caries and the risks
associated to dental implants.
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