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Posttherapy management
Source: Late Effects of Treatment for Childhood Cancer (PDQ®)–Health Professional Version, National Cancer Institute.
Source updated: April 14, 2025 · Captured 2026-09-09.
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Some studies suggest that fluoride products or chlorhexidine rinses may be beneficial in patients who have undergone radiation therapy.[28]
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Dental caries are a problematic consequence of reduced salivary quality and flow. The use of topical fluoride can dramatically reduce the frequency of caries, and saliva substitutes and sialagogues can ameliorate sequelae such as xerostomia.[19]
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For more information about oral complications in cancer patients, see Oral Complications of Cancer Therapies.
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Table 5 summarizes oral and dental late effects and the related health screenings.
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| Predisposing Therapy | Oral/Dental Effects | Health Screening/Interventions |
|---|---|---|
| CT = computed tomography; GVHD = graft-versus-host disease; HSCT = hematopoietic stem cell transplant; MRI = magnetic resonance imaging. | ||
| aAdapted from the Children's Oncology Group Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancers. | ||
| Any chemotherapy; radiation exposing oral cavity | Dental developmental abnormalities; tooth/root agenesis; microdontia; root thinning/shortening; enamel dysplasia | Dental evaluation and cleaning every 6 months |
| Regular dental care including fluoride applications | ||
| Consultation with orthodontist experienced in management of irradiated childhood cancer survivors | ||
| Baseline Panorex x-ray before dental procedures to evaluate root development | ||
| Radiation exposing oral cavity | Malocclusion; temporomandibular joint dysfunction | Dental evaluation and cleaning every 6 months |
| Regular dental care including fluoride applications | ||
| Consultation with orthodontist experienced in management of irradiated childhood cancer survivors | ||
| Baseline Panorex x-ray before dental procedures to evaluate root development | ||
| Referral to otolaryngologist for assistive devices for jaw opening | ||
| Radiation exposing oral cavity; HSCT with history of chronic GVHD | Xerostomia/salivary gland dysfunction; periodontal disease; dental caries; oral cancer (squamous cell carcinoma) | Dental evaluation and cleaning every 6 months |
| Supportive care with saliva substitutes, moistening agents, and sialogogues (pilocarpine) | ||
| Regular dental care including fluoride applications | ||
| Referral for biopsy of suspicious lesions | ||
| Radiation exposing oral cavity (≥40 Gy) | Osteoradionecrosis | History: impaired or delayed healing after dental work |
| Examination: persistent jaw pain, swelling or trismus | ||
| Imaging studies (x-ray, CT scan and/or MRI) may assist in making diagnosis | ||
| Surgical biopsy may be needed to confirm diagnosis | ||
| Consider hyperbaric oxygen treatments | ||
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