Saliva, oral microbiome and inflammatory markers in connection with treatment of cancer of the head and neck region
Cancer of the head and neck region and its’ treatment leads to many complications for both oral and general health. Reduced salivary secretion rate is a common complication because the major salivary glands are often included in the radiation field. Saliva has many important functions in the oral cavity such as to moisturize, protect and lubricate the soft tissues and teeth. Saliva contains a large number of proteins of which many can inhibit the growth of microorganisms. Another common side effect of cancer treatment is oral mucositis, an inflammation in the oral mucosa, which can be very painful and make it difficult for the patients to perform oral hygiene. A reduced salivary secretion and poor oral hygiene promotes the growth of bacteria and to colonization of microorganisms associated with oral disorders, triggering the immune defense. An increased level of cytokines associated with inflammation is seen during cancer treatment. A reduced level of streptococci, associated with good oral health, has been reported in patients with severe mucositis compared with those with mild mucositis.
To follow salivary secretion rate and saliva composition, inflammatory markers and oral microbiome in patients undergoing treatment of cancer of the head and neck region before, during and up to three months post treatment.
Patients and methods
Patients are recruited by dental hygienists in five regions. Data is collected before starting cancer treatment, every week during radiation therapy and one and three months after completed treatment. Clinical data including registration of oral mucositis (Oral mucositis assessment scale), dental plaque and gingival bleeding are collected. The stimulated salivary secretion is determined and saliva is saved pending analysis. Salivary proteins will be analyzed as well as the oral microbiome (in saliva and dental plaque samples). Inflammatory markers will be analyzed in saliva samples. The project will generate new knowledge, which can be used to improve the odontological care for patients undergoing treatment of cancer of the head and neck region.