Radiation-Induced Xerostomia and Cariogenic Dietary Habits

Abstract

Abstract PurposeDespite the availability of various prevention methods, dental caries continues to be an adverse effect of head and neck radiotherapy (RT). Since conventional approaches do not evaluate the post-treatment alterations in dietary behavior, we assessed the influence of radiation-induced xerostomia on post-RT cariogenic dietary habits.MethodsFifty-seven patients responded to the xerostomia questionnaire (XQ) and answered questions regarding daily cariogenic food and beverage (CFB) intake, daily teeth brushing, fluoride application, and subjective total taste acuity (STTA). They also underwent evaluations for the Simplified Oral Hygiene Index (OHI-S), Saxon test, number of decayed-missing-filled teeth (DMFT), and the proportion of DMFT to the test teeth (DMFT rate). Clinical records were searched for information regarding RT modalities, including the median of the mean dose to the parotid glands, post-RT duration, submandibular gland resection, whole-neck irradiation, and the DMFT value and rate before RT. The patients were divided into low- and high-XQ groups based on the median XQ summary score of 47.5 for the two sample tests. Univariable and multivariable regression analyses were used to identify independent factors for CFB intake.ResultsHigher XQ scores were associated with a significantly greater frequency of CFB intake (P=0.020). Regression analysis also identified higher XQ scores (P=0.017) as an independent risk factor for frequent CFB intake.ConclusionRadiation-induced xerostomia enhanced CFB intake for oral comfort. Therefore, radiation caries management should target xerostomia-induced dietary habits in addition to oral hygiene and fluoride application.