Dental problems and irradiation of the O.R.L. sphere: a new attitude. Preliminary results on 488 cases

High-energy radiotherapy has greatly improved the percentage of cures in cancers of the ORL sphere, but it is debatable whether the same progress has been made in the prevention of its sequels and complications. Post-radiotherapeutic dental decay, the result of asialia, is almost inevitable when the saliva glands are irradiated at doses above 3000 rads. These post-radiotherapeutic caries with their train of local infections, pains, and in some very serious but fortunately rare cases evolution towards osteonecrosis of the lower jaw, more often affected than the upper, can cancel out all the benefits derived from a cervico-facial radiotherapy from which a local sterilisation has been obtained. Post-radiotherapeutic tooth decay and its evolution towards osteoradionecrosis are described. A combined effort has been made by a team of ORL specialists, radiotherapists and dentists in an attempt to work out a dental policy aimed at reducing these complications to a minimum