Oral Biosci Med 1 (2004), No. 3 (30.09.2004)
Chlorhexidine Varnish Application and Fluoride Self-administration for Dental Caries Control in Head and Neck Irradiated Patients. A Three-year Follow-up
Llena, M. Carmen/Bagan, José V.
Head and neck irradiated patients are at greater risk of dental caries due to lack of protection resulting from quantitative and qualitative changes in their saliva. The purpose of this study was to assess the effectiveness of the application of a chlorhexidine varnish every three months and the daily use of a high-concentration fluoride in a group of head and neck irradiated patients, and to compare the rise in caries in this group with that of a control group.
A total of sixty-four patients were examined: 32 were head and neck irradiated and 32 were general clinic patients without any systemic pathology. We determined the clinical/radiological DMFS index and measured the salivary flow and pH in stimulated whole saliva at the outset of the study and after three years of three-monthly applications of a 1% chlorhexidine and thymol containing varnish (Cervitec), and self-administered high-concentration fluoride. At the start and end of the study the DMFS scores of this group of patients were compared with those of the control group.
Salivary flow was significantly higher in the patients who had received lower doses of radiotherapy and the lower the saliva flow, the lower the pH values observed. Except for the number of missing teeth, which was significantly higher in the group of patients who had been treated for squamous cell carcinoma, the caries indicators did not differ significantly by sex, diagnosis or radiotherapy dose. The rise in the number of new caries lesions and the progress of the existing untreated lesions in the study group did not differ significantly from those of the control group.
Caries risk in irradiated patients who followed a strict caries-prevention protocol is comparable to that of the general population.
Keywords: radiation therapy, dental caries, cariostatic agents