Head and neck intensity modulated radiation therapy leads to an increase of opportunistic oral pathogens

Schuurhuis, Jennifer M.; Stokman, Monique A.; Witjes, Max J. H.; Langendijk, Johannes A.; Winkelhoff, A.J. van; Vissink, Arjan; Spijkervet, Frederik

doi:10.1016/j.oraloncology.2016.05.005

Cited by 49 publications

(61 citation statements)

References 36 publications

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“…Then, the elevations of cariogenic microorganisms in RT might be understood as result of the absence or precariousness of the preventive measures and the poor hygiene conditions of the patients and their deterioration along RT 33,34 . In radiotherapy centers where preventive dentistry is considered relevant and plays a central role in the prevention of side effects of RT, populations of cariogenic cocci are under partial control 19,30 , consisting transient phenomenon 33,35,36 , and hygiene standards evidences relevant improvement during RT and follow-up period, particularly when intensity modulated radiation therapy is used, which produces less pronounced effects on the salivary glands 19,37 .…”

Section: Radiation Caries Oral Streptococci and Mucositismentioning

confidence: 99%

“…Mucositis is associated with ulcerated areas, hinder nutrition and might facilitate the deployment of local or systemic infections 5 , usually caused by opportunistic microorganisms, such as enteric pathogens, anaerobic Gramnegative rods and yeasts 7,19,20,41,42 sometimes already present in higher proportions in cancer patients before RT 23 . The presence, severity and persistence of xerostomia seem to be the main factors associated with the presence of candidiasis in irradiated patients, facilitating the colonization of surfaces that previously did not harbor these fungi, allowing the growth of yeast populations 43,44 .…”

Section: Radio-induced Mucositis and Candidiasismentioning

confidence: 99%

“…The occurrence and populations of autochthonous microorganisms of the oral microbiota may be higher among patients with head and neck squamous cell carcinoma 23 , but this phenomenon is not universal 12,19,20,48 . Alcohol and tobacco consumption and poor hygiene might facilitate oral colonization of the patients by exotic microbial species 12,20,48 .…”

Section: Mucositis Oral Bacterial Microbiota Enterobacteriaceae Andmentioning

confidence: 99%

“…In this sense, the role of the oral microbiota in the development and exacerbation of mucositis still needs clarification, but this oral condition can be exacerbated by the concomitant presence of other local and/or systemic infectious processes 16,18 . The development of xerostomia and mucositis is followed by several changes in oral microbiota, but the significance of such phenomenon remains unclear 19 . Some evidences suggest that oral environment might act as reservoirs of classical and opportunistic pathogens, facilitating the establishment of opportunistic infections, particularly in patients receiving chemotherapy and undergoing RT simultaneously 19,20 .…”

Section: Introductionmentioning

confidence: 99%

“…The development of xerostomia and mucositis is followed by several changes in oral microbiota, but the significance of such phenomenon remains unclear 19 . Some evidences suggest that oral environment might act as reservoirs of classical and opportunistic pathogens, facilitating the establishment of opportunistic infections, particularly in patients receiving chemotherapy and undergoing RT simultaneously 19,20 . In addition, it is evident the deterioration of dental health due to mucositis and radiation caries associated with the aggravation of xerostomia, amplifying the numbers of cariogenic cocci, reducing the pH of biofilm and cooperate, exacerbating the adhesion and proliferation of Candida on oral mucosa.…”

Section: Introductionmentioning

confidence: 99%

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Oral microbiota and mucositis in patients with head and neck cancer undergoing radiotherapy: literature review

Jardim¹,

Cunha-Correia²,

Okamoto³

et al. 2017

Arch Health Invest

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Oral microbiota and mucositis in patients with head and neck cancer undergoing radiotherapy: literature review AbstractThe occurrence and severity of mucositis are the main complaints of patients with head and neck cancer submitted to radiotherapy (RT). This condition appears to be associated with changes in the oral microbiota and other side effects of RT, such as xerostomia and candidiasis. The aim of this study was to evaluate the effect of RT on the oral microbiota and its impact on radioinduced mucositis through literature review. Descriptors were selected for the collection of information in different databases, especially SciELO, BIREME, LILACS and PubMed. It was decided to consider only articles published since 1985. The descriptors radiotherapy, mucositis, dental caries, xerostomia, head and neck neoplasms and health promotion were used. It was selected 91 articles specifically discussing the microbiological aspects of mucositis, dental caries, oral candidiasis and microbial effects on the oral health of cancer patients, and 59 were included in the review. It was observed that microbial contamination is a secondary phenomenon capable of exacerbate the inflammation induced by the interaction of the radiation with the oral tissues, aggravating mucositis mainly in patients who present precarious conditions of oral hygiene, which reinforces the role of preventive dentistry in the follow up of the irradiated patient. Descriptors: Radiotherapy; Mucositis; Dental Caries; Xerostomia; Head And Neck Neoplasms; Health Promotion. ResumoA ocorrência e a severidade da mucosite constituem as principais queixas dos pacientes com câncer de cabeça e pescoço submetidos à radioterapia (RT). Essa condição parece estar associada às modificações da microbiota bucal e aos demais efeitos colaterais da RT, como xerostomia e a candidíase. O presente trabalho de revisão da literatura teve como objetivo avaliar o efeito que a RT exerce sobre a microbiota bucal e seu impacto na mucosite radioinduzida através de revisão de literatura. Foram selecionados os descritores para a coleta de informações em diferentes bancos de dados, destacando-se SciELO, BIREME, LILACS e PubMed. Decidiu-se considerar apenas artigos publicados desde 1985. Utilizou-se como descritores os termos radioterapia, mucosite, cárie dentária, xerostomia, neoplasias de cabeça e pescoço e promoção da saúde. Foram selecionados 91 artigos que discutiam especificamente os aspectos microbiológicos da mucosite, cárie dentária, candidíase oral e efeitos microbianos na saúde bucal de pacientes oncológicos e 59 foram incluídos na revisão. Observou-se que a contaminação microbiana é fenômeno secundário capaz de agravar a inflamação induzida pela interação da radiação com os tecidos bucais, agravando-se, principalmente, em pacientes que apresentam condições precárias de higiene bucal, o que reforça o papel da odontologia preventiva no acompanhamento do paciente irradiado. Descritores: Radioterapia; Mucosite; Cárie Dentária; Xerostomia; Neoplasias de Cabeça e Pescoço; Promoção da...

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