Prevalence of acute periapical abscesses in head and neck cancer patients receiving radiotherapy

Aims: Head and neck cancer is a serious condition affecting the life of patients. Radiotherapy is commonly used to treat such conditions. The aim of this study was to assess the prevalence of acute periapical abscesses (PAs) in patients who received radiotherapy for head and neck cancer.Methods and results: Data on acute PAs and oropharyngeal cancer (OPC) diagnosis with or without a history of radiation therapy (RAD) was retrieved by searching the appropriate query in the database. All cases were diagnosed for acute PAs by calibrated dentists for patients admitted to urgent care. The odds ratio (OR) for the prevalence of acute PAs and its association with a history of OPC with or without RAD were then calculated. Adjustment for comorbidities such as diabetes, smoking and gingival and periodontal diseases was also done. The prevalence of acute PAs in patients with a history of OPC was significantly higher as compared to the general hospital patient population (OR 2.92, 95%CI, p < .0001). Males were more affected than females and whites were more affected than African Americans and other ethnicities. The prevalence for PAs in patients with a history of OPC and RAD was higher and the difference in prevalence was statistically significant (OR 3.61, 95%CI, p < .0001). Whites were more affected than African Americans by more than 3.5-fold. Adjustment for diabetes comorbidly affected mainly the OPC + RAD group, however, the difference remained statistically significant. Adjustment for smoking and gingival and periodontal disease reduced the OR but the difference remained statistically different.Conclusions: The high prevalence of acute PAs in patients with a history of OPC and RAD may suggest an association between these conditions warranting a meticulous medical and dental examination.