ABSTRACT
Patients undergoing radiation therapy for the head and neck are susceptible to a significant and often abrupt deterioration in their oral health. The oral morbidities of radiation therapy include but are not limited to an increased susceptibility to dental caries and periodontal disease. They also include profound and often permanent functional and sensory changes involving the oral soft tissue. These changes range from oral mucositis experienced during and soon after treatment, mucosal opportunistic infections, neurosensory disorders, and tissue fibrosis. Many of the oral soft tissue changes following radiation therapy are difficult challenges to the patients and their caregivers and require life-long strategies to alleviate their deleterious effect on basic life functions and on the quality of life. We discuss the presentation, prognosis, and management strategies of the dental structure and oral soft tissue morbidities resulting from the administration of therapeutic radiation in head and neck patient. A case for a collaborative and integrated multidisciplinary approach to the management of these patients is made, with specific recommendation to include knowledgeable and experienced oral health care professionals in the treatment team.
Subject(s)
Communicable Diseases/etiology , Dental Caries/etiology , Head and Neck Neoplasms/radiotherapy , Osteoradionecrosis/etiology , Periodontal Diseases/etiology , Salivation/radiation effects , Sensation Disorders/etiology , Stomatitis/etiology , Communicable Diseases/diagnosis , Communicable Diseases/therapy , Dental Caries/diagnosis , Dental Caries/therapy , Fibrosis , Head and Neck Neoplasms/pathology , Humans , Osteoradionecrosis/diagnosis , Osteoradionecrosis/therapy , Periodontal Diseases/diagnosis , Periodontal Diseases/therapy , Radiotherapy/adverse effects , Risk Factors , Sensation Disorders/diagnosis , Sensation Disorders/physiopathology , Sensation Disorders/therapy , Stomatitis/diagnosis , Stomatitis/therapy , Treatment OutcomeSubject(s)
Back Pain/physiopathology , Earache/physiopathology , Headache/physiopathology , Self Report , Social Media , Toothache/physiopathology , Female , Humans , MaleABSTRACT
BACKGROUND: The authors conducted a study of tweets posted on Twitter to compare self-reported toothache experiences with those of backache, earache and headache in regard to pain intensity, action taken, perceived cause and effect of pain. METHODS: From a total of 508,591 relevant tweets collected on seven nonconsecutive days, the authors randomly selected 1,204 tweets (301 per pain type) and conducted content analyses of each tweet. RESULTS: Toothaches were described as having higher pain intensity than were earaches or headaches but pain intensity comparable with that of backaches. Despite people who experience toothache being more likely to seek health care than those experiencing backaches (odds ratio [OR], 3.91; 95 percent confidence interval [CI], 1.57-9.71) or headaches (OR, 6.11; 95 percent CI, 2.16-17.25), only one in 10 people with toothaches mentioned seeking health care for their pain. People with toothaches were less likely to report an effect on daily functioning compared with those with backaches (OR, 0.13; 95 percent CI, 0.03-0.56) or earaches (OR, 0.19; 95 percent CI, 0.05-0.77). CONCLUSIONS: Using unsolicited self-reported data from Twitter, the authors found similarities and differences in the experiences of people with toothaches compared with those of people with other common pains. These findings offer insights into understanding dental pain and dental care utilization. PRACTICAL IMPLICATIONS: The use of social media, such as Twitter, to discuss health issues provides opportunities for dental professionals to better understand dental care experiences from the patients' perspective. Furthermore, social media such as Twitter offer providers the opportunity to share information with the public and to facilitate provider-patient communication.
