Open research questions in Oral health in cancer treatment
44 unresolved questions extracted from the limitations and future-work sections of 950 Oral health in cancer treatment papers in our library. Each links back to the study that raised it.
What the literature leaves open
While the findings are promising, larger multicenter trials with extended follow-up and incorporation of mechanistic endpoints are warranted to confirm the durability of response and further elucidate the under- lying biological mechanisms. Fur- ther multicenter studies are warranted to confirm these findings.
Efficacy of magnesium–calcium ionic oral rinse for primary burning mouth syndrome: a randomized, double-blind, placebo-controlled trial · 2026 · DOILimitations of the present study include potential selection bias in both groups. In the control group, children with substantial caries and treatment needs may have declined Supportive Care in Cancer (2026) 34:482 Page 11 of 12 482 clinics in Vestland County for providing office space for our examina- tions, as well as to TK Rogaland Stavanger and the Specialist Clinic in Haugesund for allowing us to use their facilities for CCS examinations. Author contribution BNT and TB collected the clinical data. BNT drafted the manuscript. JA, BNT and TB analysed the statistics. SL, DMW and TB designed the research, supervised the study and con- tributed to manuscript writing. TL also contributed to planning the study and writing the manuscript. DMW, TB and BNT recruited the participants. All the authors read and approved the final version of the manuscript. Funding Open access funding provided by University of Bergen (incl Haukeland University Hospital). The Norwegian Childhood Cancer Society. Department of Clinical Dentistry, Faculty of Medicine, Uni- versity of Bergen, Bergen, Norway. Data availability The datasets used and/or analysed during the current study are available from the corresponding author upon reasonable request.
for MOG use includes utilization of bite force to achieve full occlusion and reverse the protrusive effects of the oral appliance.15 However, habitual performance of clenching behaviors has been consistently identified in TMD literature as a contributing factor to painful TMD.20 The masseter, temporalis and the medial pterygoid muscles, are the primary clenching muscles and repetitive high-intensity activation of these muscles during teeth clenching, is identified as a risk factor for masticatory myalgia and myofascial pain.23 Stretching the jaw by opening wide lengthens the masticatory clenching muscles to restore relaxed neutral positioning. Ueda et al. 16 found that jaw stretching in combination with guided retrusion resulted in improved morning occlusal contact area and bite force after OAT. Altogether these exercises are effective to establish jaw retrusion to counteract jaw protrusion and stretch the masseter and temporalis muscles that perform clenching, independently integrating specific jaw exercises with the use of the MOG can help overcome pain-related obstacles to compliance, promote accurate repositioning of the occlusal contacts, and enhance overall comfort and effectiveness of OAT. This proposed protocol is repeatable and testable and provides opportunities for future research concerning clinical effectiveness and feasibility. Protocol for Integrating MOG and Jaw Exercises • Rest position of the tongue (6x6 #1): Repeated upward tongue positioning on the anterior one- third roof of the mouth area while performing slow diaphragmatic breathing. Cues given to find the position include saying the letter “N” or clucking the tongue. This “tongue-up, teeth-apart” activity has become the standard recommendation given by physical therapists and orofacial pain specialists to disrupt relax jaw clenching behaviors and masticatory muscle tension.21,22 • Controlled rotation (6x6 #5): Repeated Given the considerable diversity in MOG design, materials, and fabrication methods, this protocol defines a MOG as a partial maxillary anterior coverage guide lacking any posterior extension. Chairside fabrication is performed by a qualified dentist using thermoplastic material, meticulously adapted to the maxillary anterior teeth while intercuspation. This the patient ensures maximum approach ensures an accurate occlusal impression of the mandibular teeth within the guide. The dentist may modify the approach as appropriate should an alternate MOG design more effectively meet the patient's clinical needs.
A Standardized Protocol for Enhancing Oral Appliance Therapy: Integrating Morning Occlusal Guide and Jaw Exercises · 2026 · DOIThe questionnaire did not collect respondent profile or family sociodemographic data related to gender, age, parental education, and income. Future research in paediatric oncology oral health should systematically assess how sociodemographic variables and access to dental services in predominantly private healthcare systems influence parental oral health practices and oral complication outcomes.
The paper emphasizes the need for structured oral care follow-up before, during, and after cancer therapy in paediatric oncology. Future research should establish and validate evidence-based protocols for integrating practical hands-on demonstrations of oral care techniques into paediatric oncology treatment workflows across multidisciplinary teams.
The study found that only a minimal proportion of parents implemented comprehensive oral hygiene practices despite receiving instructions. Future research should develop and evaluate targeted oral health literacy resources specifically tailored to non-medical audiences in paediatric oncology, then measure their effectiveness in improving parental oral health management and treatment adherence.
The paper identifies a critical gap in actual implementation of oral care protocols despite parental instruction receipt in paediatric oncology. Future research should identify specific systemic barriers within oncology multidisciplinary teams that hinder effective oral care delivery, including barriers to integration of routine dental assessments into paediatric oncology admission protocols.
The study relied solely on parental questionnaire responses without qualitative data collection. Future research should conduct semi-structured interviews with parents and caregivers in paediatric oncology units to elicit detailed parental concerns, barriers to oral care implementation, and specific suggestions for improving oral health management in this vulnerable population.
The questionnaire recruited patients in heterogeneous treatment phases (regardless of cancer type, disease stage, treatment protocol and duration) without stratifying responses by these variables. Future research must systematically investigate how specific cancer treatment protocols, disease stages, and treatment duration differentially impact parental oral health compliance and the incidence of oral complications in paediatric oncology patients.
The study used convenience samples from only two hospitals within the same geographical region in Portugal, limiting generalizability. Future research should expand paediatric oncology oral health studies across multiple regions and healthcare systems, particularly comparing private versus public dental care access models, to assess how sociodemographic factors (parental education, income, gender, age) and healthcare system structure influence oral health practices in paediatric cancer patients.
CONCLUSIONS: Evidence on the management of oral ulcers in the oral cavity produced by MTX at low doses is scarce due to the heterogeneity of data and the measures adopted in the selected studies.
Herein the term "cGVHD-related caries" is proposed to describe this under-recognized complication of cancer treatment that may evolve in allo-HSCT recipients that develop cGVHD.
Systemic neuromodulators such as gabapentin have yielded inconsistent results and may be limited by adverse effects [12].
Efficacy of magnesium–calcium ionic oral rinse for primary burning mouth syndrome: a randomized, double-blind, placebo-controlled trial · 2026 · DOIClinical studies on caries prevention after radiotherapy to the HN are lacking and the existing ones bear extensive limitations.
Exercise must be optimally performed to prevent or control cancer symptoms, although the exact duration and intensity of exercise required to reduce cancer risk in humans have not been established.
A decrease in implant survival rate can be noted in the presence of the following situations; cytotoxic chemotherapy or the use of bisphosphonates, post radiotherapy, in the maxillary region, in the augmented bone, and in cases where dental hygiene is insufficient.
Baş-Boyun Kanseri Geçirmiş Hastalarda İmplant Uygulamalarının Uygunluğunun ve Sağ Kalım Oranlarının Değerlendirilmesi Evaluation of the Suitability and Survival Rates of Dental Implant Applications in Patients with Head and Neck Cancer · 2015 · DOI
Most-cited papers in Oral health in cancer treatment
- Prevention and Management of Osteoradionecrosis in Patients With Head and Neck Cancer Treated With Radiation Therapy: ISOO-MASCC-ASCO Guideline · Journal of Clinical Oncology · 2024 · 111 citations
- Microbiota and their role in the pathogenesis of oral mucositis · Oral Diseases · 2014 · 96 citations
- In vivo evaluation of the virucidal efficacy of chlorhexidine and povidone-iodine mouthwashes against salivary SARS-CoV-2. A randomized-controlled clinical trial · Journal of Evidence Based Dental Practice · 2021 · 66 citations
- Oral health‐related quality of life in southern Chinese following radiotherapy for nasopharyngeal carcinoma · Journal of Oral Rehabilitation · 2004 · 58 citations
- Survival of dental implants and occurrence of osteoradionecrosis in irradiated head and neck cancer patients: a systematic review and meta-analysis · Clinical Oral Investigations · 2021 · 57 citations
- The Influence of Radiation Therapy on Dental Implantology · Implant Dentistry · 2013 · 52 citations
- Salivary arecoline levels during areca nut chewing in human volunteers · Journal of Oral Pathology and Medicine · 2010 · 50 citations
- Radiation‐induced oral mucositis and periodontitis – proposal for an inter‐relationship · Oral Diseases · 2013 · 48 citations
- Osteoradionecrosis after postoperative radiotherapy for oral cavity cancer: A retrospective cohort study · Oral Oncology · 2022 · 45 citations
- The effect of therapeutic radiation on dental enamel and dentin: A systematic review · Dental Materials · 2022 · 40 citations
Most recent work
- Adverse Oral Health in Older Adults With Head and Neck Cancer (And Oral Potentially Malignant Disorders): A Systematic Review · Gerodontology · 2026
- Prospective Evaluation of KEAP1, NRF-2, NF-κB, IL-1β, and TNFα Levels in Head and Neck Cancer Patients with Oral Mucositis Undergoing Chemo-radiotherapy · Journal of international oral health · 2026
- The parents voice on oral health care from two paediatric oncology units · European Archives of Paediatric Dentistry · 2026
- A Standardized Protocol for Enhancing Oral Appliance Therapy: Integrating Morning Occlusal Guide and Jaw Exercises · Journal of Dental Sleep Medicine · 2026
- Methylene Blue Mouthwash for Oral Mucositis Pain in Cancer: An Open-Label, Non-Randomized Study · Journal of Pain & Palliative Care Pharmacotherapy · 2026
- Comparative radioprotective effects of ascorbic acid and telmisartan, alone and in combination, on gamma-irradiated mandibular bone: an experimental rat study · The Saudi Dental Journal · 2026
- Safety and Efficacy of an Led-Based Intraoral Device for Daily Photobiomodulation Therapy Prior to Radiation Treatment in Reducing Severity of Oral Mucositis in Head and Neck Cancer Patients · International Journal of Radiation Oncology*Biology*Physics · 2026
- Dental caries in childhood cancer survivors · Supportive Care in Cancer · 2026
- Acupuncture for chemotherapy-induced dysgeusia (AcuDysg): a randomized controlled trial · Supportive Care in Cancer · 2026
- The Comprehensive Repair–Inflammation Index (CRII) Predicts Tooth Extraction After Chemoradiotherapy: A Continuous and Nonlinear Modeling Analysis · Journal of Clinical Medicine · 2026
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