A randomized controlled trial comparing the effect of salivary substitute and fluoride varnish on radiation caries in irradiated head and neck cancer patients.

Abstract / Summary

Morbid effects of head and neck cancer (HNC), ensuing treatment, and ignorance of oral health care have been shown to cause multiple oral issues, including progressive radiation caries (RC). Such conditions negatively impact the quality of life in HNC survivors, are costly for healthcare systems to manage, and may generate population-level differences at local, regional, national, and global levels. To evaluate and compare the effectiveness of salivary substitute and fluoride varnish on RC in irradiated HNC patients. HNC patients meeting the inclusion criteria were randomly assigned into three groups to receive either a saliva substitute (Group I), fluoride varnish (Group II), or both (group III). After providing comprehensive oral care, the Decayed, Missing, and Filled Surfaces (DMFS) score was recorded before RT, then at 3, 6, and 12 months post-RT. Fluoride varnish was applied professionally before RT, immediately after RT, and then at 3-month intervals. Saliva substitute was advised to be used liberally at home before major meals. Four hundred eighty-two patients; 407 males and 75 females with a mean age of 51.32 (18-79) years were recruited for the study. At 12 months, complete data was available for 67 patients in Group I, 73 in Group II, and 80 in Group 3. An increase in DMFS score was statistically significant (P < .05) in all three groups and across all time points. The Bonferroni test for intergroup comparison was non-significant. Multiple overlapping factors influence the origin and progression of RC. The amalgamation of salivary gland-sparing RT, professional care, stringent home care measures, regular follow-ups, and patient education is paramount for addressing oral issues in HNC survivors.

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