The Effect of Care Training Intervention on Oral Health and Radiation-Induced Xerostomia in Patients with Head and Neck Cancer: A Quasi-Experimental Study

Abstract

Background: Head and neck cancer (HNC) is a common malignancy often treated with radiotherapy, which can lead to significant side effects, including xerostomia due to oral mucosa damage. Objectives: This study investigates the impact of a care training intervention on oral health and radiation-induced xerostomia in these patients. Methods: This quasi-experimental study was conducted in 2022 - 2023 on 60 patients with HNC undergoing chemotherapy and radiotherapy at Khatam al-Anbia and Ali ibn Abi Taleb hospitals, affiliated with Zahedan University of Medical Sciences. Patients were selected through convenience sampling and then randomly assigned to intervention (n = 30) and control (n = 30) groups. Baseline dental health was assessed using the Decayed, Missing, and Filled Teeth (DMFT) Index, and xerostomia was evaluated using the Fox Xerostomia Questionnaire and the RTOG/EORTC Grading Scale. The intervention group received a three-session care training program, while the control group received routine education. A blinded dental examiner reassessed dental health at the onset of radiotherapy, and xerostomia was measured at the end of treatment. Data analysis was performed using SPSS-26 with paired t-test, independent t-test, chi-square, and Fisher’s exact test, with a significance level of P < 0.05. Results: A total of 60 participants were enrolled, including 31 men (51.6%) and 29 women (48.4%), aged 29 - 58 years. The majority had no history of addiction (66.6%) or underlying disease (76.6%). At baseline, there were no significant differences between the intervention and control groups in objective xerostomia (P = 0.15) or DMFT Index distribution (P = 0.46). The mean number of DMFT was comparable between groups, with slightly more decayed teeth (3.63 ± 1.88 vs. 3.16 ± 1.72) and more filled teeth (2.86 ± 1.97 vs. 2.53 ± 1.35) in the control group; differences were not statistically significant. Conclusions: Despite numerous studies in this area, effective treatments for radiation-induced salivary gland dysfunction remain limited. In this study, no significant differences were found between the intervention and control groups in terms of xerostomia or dental health. Given the high prevalence of xerostomia in patients with HNC and its negative impact on oral health, further research is needed to identify more effective interventions to address this common complication, especially in the context of treatments like chemotherapy and radiotherapy.