Oral Complications of Head and Neck Cancer Therapy

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Diagnosis	Clinical manifestation	Symptoms	Site
Mucositis	Painful ulcerations covered by removable pseudomembranes	Pain	nonkeratinized mucosa; buccal mucosa, lateral tongue, soft palate, floor of mouth
Candidiasis	Removable white pseudomembranes	Burning sensation, mucosal soreness, taste alterations	Dorsal side of the tongue, soft and hard palate, labial commissure
Herpes	Small vesicles that eventually rupture to become shallow painful ulcerations	Pain	Keratinized oral tissues, lips
Bacterial infections	Necrotising ulcerative gingivitis, periodontitis	Pain, bleeding	Gingiva
Aphthous like (aphthoid) lesions	Single or multiple, painful, well-circumscribed, round/ovoid superficial by an erythematous halo ulcers, with a gray central area, surrounded	Pain	Nonkeratinized oral tissues; buccal mucosa, soft palate, ventral and lateral side of the tongue, floor of the mouth
Lichenoid reactions	Whitish papules, reticular or linear, confluent in places, sometimes with erythema	Pain, soreness, or asymptomatic	Dorsal and lateral side of the tongue, lips, gingiva, hard palate, buccal mucosa

Complications

Acute	Chronic
Oral Mucositis	Xerostomia
Pain	Pain
Xerostomia	Trismus
Dysgeusia	Dysgeusia
Infections	Infections
Lichenoid reactions	Dental caries
Aphthous lesions	Osteoradionecrosis of the jawMedication related necrosis of the jaw

RT	CT	TT	IT
Mucositis	Mucositis	Mucositis	Mucositis
Dysgeusia	Dysgeusia		Dysgeusia
Xerostomia	Xerostomia	Xerostomia	Xerostomia
Infections	Infections
Dyspagia	Dyspagia	Dyspagia
		Aphthoid lesions
			Lichenoid reactions
Pain	Pain	Pain	Pain
Neuropathy	Neuropathy
Trismus, fibrosis
Dental, periodontal complications	Dental, Periodontal complications
Osteoradionecrosis	Osteonecrosis related to medication		Osteonecrosis related to medication

Term	Definition

Oral Mucositis	Inflammation of oral mucosa resulting from chemotherapeutic agents or ionizing radiation, typically manifesting as erythema or ulcerations
Stomatitis	Refers to any inflammatory condition of oral tissue, including mucosa, periapices, and periodontium and includes infections of oral tissues as well as oral mucositis
Nociceptive Pain	Arises from damage to non-neural tissues due to the activation of nociceptors
Neuropathic Pain	Is caused by damage of the somatosensory nervous system
Xerostomia	Subjective feeling of oral dryness
Salivary gland dysfunction	Changes in quantity and/or quality of saliva
Salivary gland hypofunction	Decreased salivary output.
Hyposalivation	Decreased salivary output, due to salivary gland hypofunction.Whole saliva flow rate: unstimulated saliva ≤0.1 ml/min; stimulated saliva <0.7 ml/min
Dry mouth	Term used to indicate either xerostomia or salivary gland hypofunction or both
Dysgeusia	Taste alteration
Ageusia	Loss of taste
Hypergeusia	Heightened taste sensitivity
Hypogeusia	Reduced taste sensitivity

Publication timeframe:: 4 times per year
Journal Subjects:: Medicine, Clinical Medicine, Internal Medicine, Haematology, Oncology