2. Narges Mirjalili

4. 1-3 The significant role of oral care givers among patients with nasopharyngeal carcinoma Why we need simple and cheap preventive oral cares 4-6 Reviewing the most prominent adverse effects of head and neck radiation therapy Brief overview of effective preventive measures 7 Going through a short list of relatively cost-effective preventive measures Reminding their positive influence

5. Epidemiology The number of new cases is expected to rise by about 70% over the next 2 decades. (Report on 2012) More than 60% of world’s total new annual cases occur in Africa, Asia and Central and South America. These regions account for 70% of the world’s cancer deaths. The number of new cases is expected to rise by about 70% over the next 2 decades. (Report on 2012) More than 60% of world’s total new annual cases occur in Africa, Asia and Central and South America. These regions account for 70% of the world’s cancer deaths. NPC represents about 0.7% of the global cancer burden

8. One of the prime limiting factors of radiation for advanced head and neck carcinoma.

9. The most significant long-term complication of radiotherapy in the head and neck region

10. A late effect, usually with a rapid onset and quick progress Characterized by the absence of acute pain Topical Fluoride preparations Radiation-induced caries as the late effect of radiation therapy in the head and neck region Katarzyna Dobroś, Justyna Hajto-Bryk, Małgorzata Wróblewska, Joanna Zarzecka. Contemp Oncol (Pozn) 2015; 19 (5)

11. Eliminating all sources of infection & reducing the CFU IMRT Amifostine Pilocarpine Neutral fluoride preparation Eliminating all sources of infection & reducing the CFU Hydration & saliva stimulation (start before and continue through, if possible) In-office fluoride (before radiation) Fluoride mouth wash, switch to Xylitol mouthwash Ideal Preventive Protocol Compromised Preventive Protocol

12. Thanks for your attention