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| ID | Type | Description | Link |
|---|---|---|---|
| 1U01DE022939-01 | U.S. NIH Grant/Contract | View source |
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| Name | Class |
|---|---|
| National Institute of Dental and Craniofacial Research (NIDCR) | NIH |
| University of Minnesota | OTHER |
| UConn Health | OTHER |
| University of Pennsylvania |
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The purpose of this study is to measure the two-year rate of tooth loss in patients who have received external beam radiation therapy with curative intent for head and neck cancer. The study will also evaluate the sequelae of radiation therapy and oral complications that may occur as a result to receiving radiation therapy.
This is a prospective cohort study to document dental and other oral outcomes in patients who receive external beam radiation therapy with curative intent, as part of clinical care for a head and neck cancer. Five hundred and seventy-five participants will be enrolled. All study participants will receive a baseline oral examination prior to the start of radiation therapy. Follow-up examinations and data collection will be conducted at six-month intervals up to 2 years after the start of radiation therapy. The primary outcome will be the two-year rate of tooth loss. Secondary outcomes will include measures of dental caries, periodontal health, salivary flow, and exposed bone/osteoradionecrosis.
The proposed research will provide more information to inform the community about the sequelae of Radiation Therapy (RT) in head and neck cancer patients, to refine current guidelines and to design future studies on the dental management of these patients.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients receiving head and neck RT | No intervention |
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| Measure | Description | Time Frame |
|---|---|---|
| Tooth loss | The primary outcome measure is the two-year rate of tooth loss in patients who have received at least one session of external beam radiation therapy with curative intent for head and neck cancer. "Tooth loss" will be defined as a dental extraction that has been performed or recommended. Since dental extractions are often avoided in this population because of the increased risk of osteoradionecrosis (ORN), tooth loss will also include teeth having a dental procedure to avoid extraction of a tooth that would otherwise have been extracted if the individual had not received RT and teeth recommended for extraction that have not been treated. The following categories will constitute teeth that would otherwise be recommended for extraction:
| Two Years |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of exposed intraoral bone | Two year incidence of exposed intraoral bone, suggestive of ORN. This will be defined as exposed maxillary or mandibular bone with an avascular appearance in a quadrant that has received RT | Two Years |
| Extraction complications |
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Inclusion Criteria:
OR
Diagnosed with a non-SCC, non-SGC malignancy of the head and neck region, and intends to receive RT, with or without concomitant chemotherapy. The subject must be expected to receive at least 4500 cGy to one of the following sites:
At least 1 natural tooth remaining or expected to remain in the mouth after completion of the pre-RT dental extractions, if any;
Willing to comply with all study procedures;
Willing to participate for the duration of the study.
Exclusion Criteria:
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Head and Neck Radiation Oncology patients
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| Name | Affiliation | Role |
|---|---|---|
| Michael T Brennan, DDS, MHS | Wake Forest University Health Sciences | Study Chair |
| Rajesh Lalla, DDS, PhD | University of Connecticut Health Center - School of Dental Medicine | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Connecticut Health Center - School of Dental Medicine | Farmington | Connecticut | 06030 | United States | ||
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 29173331 | Result | Brennan MT, Treister NS, Sollecito TP, Schmidt BL, Patton LL, Mohammadi K, Long Simpson L, Voelker H, Hodges JS, Lalla RV. Dental disease before radiotherapy in patients with head and neck cancer: Clinical Registry of Dental Outcomes in Head and Neck Cancer Patients. J Am Dent Assoc. 2017 Dec;148(12):868-877. doi: 10.1016/j.adaj.2017.09.011. | |
| 28675770 | Result | Lalla RV, Treister N, Sollecito T, Schmidt B, Patton LL, Mohammadi K, Hodges JS, Brennan MT; OraRad Study Group. Oral complications at 6 months after radiation therapy for head and neck cancer. Oral Dis. 2017 Nov;23(8):1134-1143. doi: 10.1111/odi.12710. Epub 2017 Aug 3. |
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| ID | Term |
|---|---|
| D006258 | Head and Neck Neoplasms |
| D009057 | Stomatognathic Diseases |
| D014987 | Xerostomia |
| D010025 | Osteoradionecrosis |
| ID | Term |
|---|---|
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D012466 | Salivary Gland Diseases |
| D009059 | Mouth Diseases |
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| OTHER |
| Brigham and Women's Hospital | OTHER |
| NYU Langone Health | OTHER |
| University of North Carolina | OTHER |
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Incidence of post-extraction complications |
| Within 14 days following procedure |
| Decayed, Missing or Filled Surfaces (DMFS) Index | Two year change in DMFS - Decayed, Missing or Filled Surfaces Index | Baseline, 24 months |
| Periodontal Measures | Two year change in periodontal measures | Baseline, 24 months |
| Stimulated Salivary Flow Rate | 18 month changes in stimulated whole salivary flow rates | Baseline, 18 months |
| Trismus measure | Two year change in mouth opening in mm | Baseline, 24 months |
| Topical fluoride use for caries prevention | Two year use of fluoride to prevent new caries | Baseline, 24 months |
| Chronic Oral Mucositis Incidence | Two year chronic oral mucositis incidence | Baseline, 24 months |
| Quality of Life after Radiation Therapy | Two year change in radiation therapy-specific quality of life measures | Baseline, 24 months |
| Oral Cancer Pain Scale | Two year change in pain scores as measured with the University of California at San Francisco (UCSF) oral cancer pain scale | Baseline, 24 months |
| Brigham and Women's Hospital |
| Boston |
| Massachusetts |
| 02120 |
| United States |
| New York University - College of Dentistry | New York | New York | 10010 | United States |
| University of North Carolina - School of Dentistry | Chapel Hill | North Carolina | 27599 | United States |
| Carolinas Medical Center - Dental Clinic | Charlotte | North Carolina | 28203 | United States |
| University of Pennsylvania - School of Dental Medicine | Philadelphia | Pennsylvania | 19104 | United States |
| 28241807 | Result | Lalla RV, Long-Simpson L, Hodges JS, Treister N, Sollecito T, Schmidt B, Patton LL, Brennan MT; OraRad Study Group. Clinical registry of dental outcomes in head and neck cancer patients (OraRad): rationale, methods, and recruitment considerations. BMC Oral Health. 2017 Feb 27;17(1):59. doi: 10.1186/s12903-017-0344-y. |
| 32991009 | Result | Brennan MT, Treister NS, Sollecito TP, Schmidt BL, Patton LL, Yang Y, Lin A, Elting LS, Hodges JS, Lalla RV. Epidemiologic factors in patients with advanced head and neck cancer treated with radiation therapy. Head Neck. 2021 Jan;43(1):164-172. doi: 10.1002/hed.26468. Epub 2020 Sep 29. |
| 32451231 | Result | Talevi V, Wen J, Lalla RV, Brennan MT, Mougeot FB, Mougeot JC. Identification of single nucleotide pleomorphisms associated with periodontal disease in head and neck cancer irradiation patients by exome sequencing. Oral Surg Oral Med Oral Pathol Oral Radiol. 2020 Jul;130(1):32-42.e4. doi: 10.1016/j.oooo.2020.02.013. Epub 2020 May 22. |
| 30891159 | Result | Mougeot JC, Stevens CB, Almon KG, Paster BJ, Lalla RV, Brennan MT, Mougeot FB. Caries-associated oral microbiome in head and neck cancer radiation patients: a longitudinal study. J Oral Microbiol. 2019 Mar 8;11(1):1586421. doi: 10.1080/20002297.2019.1586421. eCollection 2019. |
| 34879248 | Result | Brennan MT, Treister NS, Sollecito TP, Schmidt BL, Patton LL, Lin A, Elting LS, Hodges JS, Lalla RV. Tooth Failure Post-Radiotherapy in Head and Neck Cancer: Primary Report of the Clinical Registry of Dental Outcomes in Head and Neck Cancer Patients (OraRad) Study. Int J Radiat Oncol Biol Phys. 2022 Jun 1;113(2):320-330. doi: 10.1016/j.ijrobp.2021.11.021. Epub 2021 Dec 5. |
| 35304084 | Result | Lalla RV, Treister NS, Sollecito TP, Schmidt BL, Patton LL, Helgeson ES, Lin A, Rybczyk C, Dowsett R, Hegde U, Boyd TS, Duplinsky TG, Brennan MT. Radiation therapy for head and neck cancer leads to gingival recession associated with dental caries. Oral Surg Oral Med Oral Pathol Oral Radiol. 2022 May;133(5):539-546. doi: 10.1016/j.oooo.2022.01.016. Epub 2022 Jan 31. |
| 35403479 | Result | Brennan MT, Treister NS, Sollecito TP, Schmidt BL, Patton LL, Lin A, Elting LS, Helgeson ES, Lalla RV. Dental Caries Postradiotherapy in Head and Neck Cancer. JDR Clin Trans Res. 2023 Jul;8(3):234-243. doi: 10.1177/23800844221086563. Epub 2022 Apr 11. |
| 35231809 | Result | Lin A, Helgeson ES, Treister NS, Schmidt BL, Patton LL, Elting LS, Lalla RV, Brennan MT, Sollecito TP. The impact of head and neck radiotherapy on salivary flow and quality of life: Results of the ORARAD study. Oral Oncol. 2022 Apr;127:105783. doi: 10.1016/j.oraloncology.2022.105783. Epub 2022 Feb 26. |
| 34665873 | Result | Treister NS, Brennan MT, Sollecito TP, Schmidt BL, Patton LL, Mitchell R, Haddad RI, Tishler RB, Lin A, Shadick R, Hodges JS, Lalla RV. Exposed bone in patients with head and neck cancer treated with radiation therapy: An analysis of the Observational Study of Dental Outcomes in Head and Neck Cancer Patients (OraRad). Cancer. 2022 Feb 1;128(3):487-496. doi: 10.1002/cncr.33948. Epub 2021 Oct 19. |
| 34242067 | Result | Ward MC, Carpenter MD, Noll J, Carrizosa D, Moeller BJ, Helgeson ES, Lalla RV, Brennan MT. Oncologists' Perspective on Dental Care Around the Treatment of Head and Neck Cancer: A Pattern of Practice Survey. JCO Oncol Pract. 2022 Jan;18(1):e28-e35. doi: 10.1200/OP.20.00913. Epub 2021 Jul 9. |
| 36717342 | Result | Threet EJ, Napenas JJ, Petersen C, Mitchell R, Long-Simpson L, Shadick R, Valentino KC, Rybczyk CA, Blake JA, Brown MC, Aidoo R, Helgeson ES, Lalla RV, Brennan MT. Survey of experiences and barriers to dental care post-head and neck cancer in OraRad study participants. Oral Surg Oral Med Oral Pathol Oral Radiol. 2023 Apr;135(4):501-509. doi: 10.1016/j.oooo.2022.11.011. Epub 2022 Dec 13. |
| 37236706 | Result | Lalla RV, Hodges JS, Treister NS, Sollecito TP, Schmidt BL, Patton LL, Lin A, Brennan MT. Tooth-level predictors of tooth loss and exposed bone after radiation therapy for head and neck cancer. J Am Dent Assoc. 2023 Jun;154(6):519-528.e4. doi: 10.1016/j.adaj.2023.03.009. |
| 37079106 | Result | Patton LL, Helgeson ES, Brennan MT, Treister NS, Sollecito TP, Schmidt BL, Lin A, Chera BS, Lalla RV. Oral health-related quality of life after radiation therapy for head and neck cancer: the OraRad study. Support Care Cancer. 2023 Apr 20;31(5):286. doi: 10.1007/s00520-023-07750-2. |
| 41781851 | Result | Mougeot JC, Beckman MF, Henry AA, Lalla RV, Brennan MT, Mougeot FB. Oral dryness related symptoms in radiation-treated head and neck cancer patients: a pilot study of oral microbiome composition and function. BMC Microbiol. 2026 Mar 4;26(1):334. doi: 10.1186/s12866-026-04885-0. |
| 40784870 | Result | Rose AM, Helgeson ES, Valentino KC, Lalla RV, Treister NS, Schmidt BL, Patton LL, Lin A, Brennan MT, Sollecito TP. The impact of medications on salivary flow and oral health-related quality of life in postradiation head and neck cancer patients: results of the OraRad study. Oral Surg Oral Med Oral Pathol Oral Radiol. 2025 Nov;140(5):577-586. doi: 10.1016/j.oooo.2025.06.019. Epub 2025 Jul 5. |
| 39005202 | Result | Lalla RV, Helgeson ES, Virk K, Lu H, Treister NS, Sollecito TP, Schmidt BL, Patton LL, Lin A, Brennan MT. Females have lower salivary flow than males, before and after radiation therapy for head/neck cancer. Oral Dis. 2025 Mar;31(3):857-864. doi: 10.1111/odi.15068. Epub 2024 Jul 15. |
| 38456849 | Result | Lim J, Helgeson ES, Lalla RV, Sollecito TP, Treister NS, Schmidt BL, Patton LL, Lin A, Milas Z, Brennan MT. Factors associated with oral hygiene compliance in patients treated with radiation therapy for head and neck cancer. J Am Dent Assoc. 2024 Apr;155(4):319-328.e2. doi: 10.1016/j.adaj.2023.11.018. Epub 2024 Mar 7. |
| 38262773 | Result | Sollecito TP, Helgeson ES, Lalla RV, Treister NS, Schmidt BL, Patton LL, Lin A, Brennan MT. Reduced mouth opening in patients with head and neck cancer treated with radiation therapy: an analysis of the Clinical Registry of Dental Outcomes in Head and Neck Cancer Patients (OraRad). Oral Surg Oral Med Oral Pathol Oral Radiol. 2024 Mar;137(3):264-273. doi: 10.1016/j.oooo.2023.11.012. Epub 2023 Nov 26. |
| D011832 |
| Radiation Injuries |
| D014947 | Wounds and Injuries |