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Medically Compromised Patients Medicine Oncology Oral Radiology Supporting Your Practice

What are the effects of radiotherapy on dental hard tissue?

This summary is based on the article published in the journal of Clinical Oral Investigation: The effect of radiotherapy on dental hard tissue. A systematic review (January 2014)

H. F. J. Lieshout & C. P. Bots


Decay of teeth, erosion and disintegration of hard dental tissue are clinically often seen side effects after radiotherapy for tumours in the head and neck region.

Purpose of the Review

To investigate if these side effects are due to structural changes in dental hard tissues, the current literature was searched. It can influence the quality of life gravely.


  • Tooth destruction occurs often and soon after irradiation.
  • There is no difference between decay in irradiated and non-irradiated teeth. The locations and the progressiveness of the destruction are different in irradiated then in nonirradiated teeth.
  • Several studies show changes in the structure and micro hardness of enamel, the dentinoenamel junction (DEJ) and dentin. The biomechanical properties are dramatically decreased. The odds of moderate/severe tooth damage increased with the irradiation dose.

Key Findings

  • The results of this systematic review show a great amount of change and damage at all levels of the hard dental tissues, enamel, DEJ and dentin.
  • These findings substantiate the idea that the formation of recurrent and atypical patterns of dental caries in irradiated teeth is, not only due to loss of saliva but a combination of both hyposalivation and the direct effects on hard dental tissue.
  • The formation of atypical caries is furthermore increased due to poor oral hygiene, the increase of soft and carbohydrate-rich substance and changes of the bacterial micro flora and proteins.


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