Management of Radiation-Induced Dental Caries – A Literature Review

Kristi Truong

Francis Mante

Truong, Kristi
Faculty / Advisor: Mante, Francis
University of Pennsylvania School of Dental Medicine, Department of Preventive and Restorative Sciences


The purpose of this literature review was to indicate the various management methods for patients undergoing radiotherapy for head and neck cancers that are prone to oral sequalae. By evaluating the literature, the objective is to identify gaps in research.


An electronic search was conducted in the PubMed database for scientific articles including systemic reviews, in vitro or in vivo studies, and case reports published in all languages from all years. Keys words related to radiation caries and management were used. The primary search terms in combination with radiation caries included: treatment, prevention, dental decay, xerostomia, silver diamine fluoride, IMRT, fluoride gel, chlorohexidine, carbamide peroxide, restoration, and glass ionomer. A manual search from the reference lists of relevant articles was also reviewed.


From the literature, it is evident that the most crucial methods are adequate oral hygiene and fluoride utilization prior, during, and after radiotherapy. Also, managing the effects of hyposalivation is essential to creating an oral environment less conducive to caries. If radiation caries is not preventable, it can be restored with composite resins and resin-modified glass ionomer cements. Additionally, there are emerging treatments that target the risk factors for dental decay. These techniques may have potential to prevent and treat radiation caries, but more research is required. To effectively reduce radiation caries, the fundamental approach is to inhibit several risk factors by using more than one management technique.


Patients undergoing radiotherapy for head and neck cancers are prone to oral sequalae. Particularly, the direct and indirect effects of treatment causes radiation-induced caries, which in severe cases, it can result in edentulism. To improve the quality of life of these patients’, there are several management techniques to prevent and alleviate radiation-induced caries prior, during, and post-radiation. The current methods are adequate and beneficial for these patients. But there are potential emerging methods that can be used to prevent radiation caries that requires further experimentation.