Source: Elsevier Global Medical News Late oral effects of head and neck cancer therapy are "multiple, underreported, and under-appreciated. "That is the perspective of Joel Epstein, D.M.D., who has worked extensively with head and neck cancer patients experiencing severe dental and other oral problems following radiation therapy. "The acute complications of head and neck cancer therapy are pretty well known, but the late complications are underappreciated," Dr.  Epstein, director of oral medicine at City of Hope National Medical Center, Duarte, Calif., told attendees at the symposium. As head and neck cancer treatments have advanced and patients are living longer, the spectrum of treatment complications has shifted, he explained. In a 5-year, prospective longitudinal study of 122 patients with oral carcinoma, dry mouth, sticky saliva, speech changes, dental problems, and sleep disturbance were reported by all patients except those treated only with surgery. These complications persisted at 1 and 5 years and affected quality of life (Head Neck 2008;30:461-70). According to Dr. Epstein, the data illustrate the need for better collaboration between oncologists and dentists. "While people discuss  the concept of multidisciplinary [and] interdisciplinary teams for the benefit of our patients, it is unfortunate that dentistry developed  separately from physicians and surgeons. So while we need to interact, we're not really well prepared to do so, particularly in the  community," he said. Clinically, it's important to evaluate oral care, including brushing, flossing, fluoride, and tobacco abstinence, at all head and neck cancer treatment follow-up visits. Patients should be assessed for xerostomia, speech, swallowing, mucosal sensitivity, and taste. Head and neck and oral exams should include assessments for [...]