article · BMC Oral Health
Radiotherapy is a standard treatment for head and neck cancer, but it commonly leads to adverse complications in oral tissues. An examination of 189 head and neck cancer patients following radiation therapy at a centre in Cairo revealed that 96.8 percent suffered from periodontal disease. Most of these individuals presented with periodontitis rather than milder gingivitis, with the advanced stage IV form being the most widespread. Analyses demonstrated that greater disease severity correlated with higher radiation doses, increased plaque levels, and more pronounced clinical oral dryness. Conversely, lower salivary flow rates and lower body mass index measurements were associated with more advanced periodontitis stages. The overall number of radiation therapy fractions did not show a statistically significant relationship with disease severity. These results highlight a considerable burden of oral tissue damage among patients undergoing radiation treatment.
Radiation treatment for head and neck cancer can severely damage oral health, yet the exact prevalence of post-treatment gum disease has remained unclear. Demonstrating that nearly all assessed patients develop periodontal complications, predominantly in advanced stages, helps healthcare providers identify clinical risk indicators, such as reduced saliva and dry mouth, to better structure patient monitoring and preventive interventions.
The abstract does not indicate a clear commercial application pathway, as it presents observational findings from a cross-sectional clinical study intended to inform future preventive care and clinical management research.
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BACKGROUND: Patients with head and neck cancer (HNC) receiving radiation therapy (RT) have complications affecting both general and dental health. While RT is effective against HNC, it negatively impacts oral tissues, including changes in periodontal attachment. This study aimed to evaluate the frequency of periodontal disease among HNC patients after RT in a sample of the Egyptian population, as well as to assess the associated risk factors. MATERIALS AND METHODS: A prospective cross-sectional study was conducted on 189 HNC patients attending a radiation center in Cairo, Egypt. Eligible patients underwent a full periodontal examination including plaque index (PI), bleeding on probing (BOP), clinical attachment level (CAL), and probing pocket depth (PPD). Subsequently, Clinical Oral Dryness Score (CODS), salivary flow rate and body mass index (BMI) were assessed to examine associations with periodontal health. RESULTS: Periodontal disease was diagnosed in 183 (96.8%) HNC patients. Among them, 174 (95.08%) cases were diagnosed as periodontitis and 9 (4.9%) as gingivitis. The distribution of periodontitis different stages was as follows: Stage I was found in 21 (12.07%) cases, Stage II in 30 (17.24%), Stage III in 55 (31.61%), and Stage IV in 68 (39.08%). The correlation between the number of RT fractions and periodontal disease severity was not statistically significant (p = 0.837). However, there was a strong negative correlation between periodontitis stage and both body mass index (BMI) and salivary flow rate. In contrast, strong positive correlations were observed between periodontitis severity and RT dose, plaque percentage, and Clinical Oral Dryness Score (CODS). CONCLUSIONS: The frequency of periodontitis in the studied sample of HNC patients post RT was 95.08%, reflecting a notably high burden. The most prevalent periodontitis stage was the severe form (Stage IV). Higher periodontitis severity was found to be positively associated with RT dose, plaque percentage, and CODS, suggesting factors to plan future investigation on preventive care in HNC patients. While causality cannot be inferred due to the study design, these findings could be useful in developing more effective clinical management strategies in future research. TRIAL REGISTRATION: The study was retrospectively registered on 29/10/2024 at ClinicalTrials.gov (NCT06667362).
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DOI: 10.1186/s12903-025-06391-7
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